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LIBRARY OF CONGRESS. 



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UNITED STATES OF AMERICA. 


















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NURSERY PROBLEMS 



EDITED BY 



Dr. LEROY M. YALE 



>*1 



OF i 



•OCT 7 n 

^ Sf WASH'.* 6 , 



THE CONTEMPORARY PUBLISHING COMPANY 
NEW YORK AND PHILADELPHIA 

1893 



(tl^Cfuu, ^ 



Copyright, i8g3. 
THE CONTEMPORARY PUBLISHING COMPANY. 



•■HE collection of "Nursery Problems" herewith offered 
to the public is made up of contributions to the columns 
of Babyhood: the Mother's Nursery Guide. The in- 
quiries addressed to the medical editor by anxious mothers 
on a great variety of subjects, with the replies thereto, prov- 
ed in their printed form so popular a feature of the maga- 
zine that a careful selection, it was thought, could not fail 
to interest and benefit a large circle of new readers. The 
Letters in this volume, it is needless to say, are all genuine, 
and they will be found to cover a wide range of topics bear- 
ing upon the welfare of young children. 



TABLE OF CONTENTS. 



Feeding . 
Milk . . 
Weaning 
Diet . . 
Bleeping 
Teething 



PAGE. PAGE. 

5 Defects and Blemishes 144 



23 The Teeth .... 


. . . 155 


32 The Eyes .... 


... 162 


42 The Ears .... 


... 166 


72 The Hair . . . . 


... 172 


84 The Feet .... 


... 176 



Hygiene and Sanitation 91 The Care of the Child . 180 

Constipation 100 The Bath 185 

Digestive Difficulties . 105 Crying 193 

Colds Ill Walking 197 

Whooping Cough. . 116 Questions of Dress . . 201 

Eruptions L19 Traveling 21 1 

Minor Ailments and The Mother 218 

Troubles L27 Miscellaneous. 229 



Nursery Problems. 



FEEDING. 



Teaching Baby to Eat. 

My six-months old baby is a large twenty-four pound boy, who 
has never been sick and is just as healthy and happy as a baby can be. 
Two teeth are now through without any trouble, and this leads me to 
suppose the time has arrived for feeding him, as up to the present he 
has never tasted anything but milk of nature's own providing. There 
seems as yet to be no lack of this natural supply, but is not the presence 
of the teeth an indication that he ought now to be taught to eat? If 
bo, what food ought first to be given him, how often, and in what 
quantities? By answering the above you will greatly oblige 

Went Virginia. An Anxious Mother. 

■ P. S. — Ought little babies to drink water — cold water? 

The presence of teeth is not an indication that he ought 
now to be taught to eat. Inferences from "indications" have 
to be draw 11 very carefully, or else we shall overlook very 
evident counter-indications. If the child were taught to 
take artificial Pood bis two teeth (incisors) would be of little 
help to him ; lie cannot bite liquid food with them, and he 
Cannot i-bcw solid food until be gets bis molars. Thiscbild's 
weight and prompt dentition are evidence, so far as tbey go, 
of bis health and proper nutrition. The question for yon bo 
decide is bow much Longer you can properly nourish him 

alone. 'Ibis question you may have l<> refer to your family 

physician. When you have decided this you can begin to 
teach the child t<> take artificial food as a preparation for 



NURSERY PROBLEMS. 



complete weaning. Cool water may be given to babies, but 
not iced water, as a rule. They often are thirsty and nurse 
only to quench thirst and not hunger. The quantity of 
water given at one time should be small. 



Small Appetite. 

I would like your opinion of a little boy who has always had a 
very slender appetite. He will be four years old next June, weighs 
about 40 pounds, is rather large and tall for his age, and has always 
seemed a remarkably well child. His looks certainly give evidence 
of perfect health, his bowels are always in excellent condition, and he 
is generally active and happy. He goes to bed at six o'clock, and 
usually sleeps until half-past six or seven the next morning. 

Occasionally lie has eaten two eggs for breakfast with relish, but 
the occasions are very rare, and after a whole morning's play, or an 
entire afternoon in the open air, he sits down to a nicely prepared meal 
with perfect indifference. If diverted by a story, and repeatedly re- 
minded to take another taste, he will for a while eat mechanically, but 
sometimes he seems too languid (the languor characterizes no other 
part of the day) for even this effort, and it becomes necessary to carry 
the spoon to his mouth. He rarely asks for anything between meals, 
except occasionally a plain sugar cooky. The only thing which he takes 
with any regularity is a cup of milk three times a day. The only 
vegetable he will eat is onion. Oysters, soft custard, bananas and 
oranges meet with more favor than anything else. Candy he likes, but 
little is allowed and that of the simplest. His food has been the sub- 
ject of much thought, and variety has been sought. On the other 
hand, the experiment has been tried of ignoring his apparent reluctance 
and allowing him to follow his own inclinations, in which case it has 
seemed probable that he would dispense with eating. The condition 
seems to have been born with him, as it certainly does not result from 
any lack of system in his care. 

A year ago he was examined by a physician and pronounced in 
good condition. Could rapid growth be a cause, and if so is there rea- 
son for concern ? D<> you consider it a case for a physician? 

Portland, Me. A New England Mother. 



FEEDTXO. 



As the case is recounted there is no clue to a cause of the 
slender appetite. Children, like adults, vary very much in 
this particular. It is, however, very unusual to find so 
persistent and marked an indifference to food. If the cup of 
milk which he takes three times a day is a large one he gets 
in that way a good deal of nutriment, so too in soft custard, 
and it may be that he is not so very much underfed after 
all. The notable point is the indifference. At all events he 
has, on what he does eat, much or little, gained enough sus- 
tenance to grow rapidly, to be "rather tall and large for his 
age," and to have a good weight also. We should not think 
that rapid growth would be a cause of want of appetite. It 
sometimes seems to be the cause of want of strength, at least 
is associated with it. We do not think it a case for a physi- 
cian in the sense of thinking him ill. We do think it is, how- 
ever, in the sense that it is wise whenever a child in any 
physical way departs from the ordinary standard to have 
him periodically thoroughly looked over, provided you 
know any physician Mho will take the time to do it care- 
fully, and keep a memorandum from time to time. In this 
way little abnormal tendencies may be recognized and cor- 
rected if they mean disease, or their true value be put upon 
them if they are only personal idiosyncrasies. 



Slow Growth. 

My baby is between five and six weeks old. He is small, but 
seems perfectly well, is notthin, has good color and looks bright, sleeps 
well, has very little colic, and cries but little. We are obliged to feed 
him on condensed milk, [t seems to agree with him and satisfies him. 
1 prepare it by using six tablespoonfuls of boiled water, three of 
lime-water, one and a hall teaspoonfuls of milk, and a little salt. He 

takes this portion from a cup at intervals of three hours (excepting at 
night), six limes (luring the twenty-four, making in all about a quart 



NURSERY PROBLEMS. 



of the prepared milk. Yet he does not grow. He weighs no more 
now than when one week old (seven pounds). Since two weeks old he 
has not been fed after ten at night until three or four in the morning. 
But I cannot say that so far my efforts in this direction have met 
with success. He is just as apt to wake at one or two o'clock and pro- 
test most vigorously, as to sleep through. I suppose perseverance will 
conquer at last, but it seems to take a long time. 

(1) Now, can you suggest to me any reason why my baby does 
not increase in weight ? 

(2) What is the trouble with the night-feeding? Should I try to 
make him go still longer without food ? 

I can really think of no reason myself why he should not gain. 
His food seems to be well digested, he has plenty of fresh air, and in 
every way that T can think of is well cared for. I am very anxious 
to rear him intelligently and hygienically. 

Be, Land, Fla. M - V - B - 

(1) As we can understand the case there is no evidence of 
any fault in health except the failure to grow. The child is 
still pretty young. It will sometimes happen that when a 
child is weaned the weight remains unchanged for some 
weeks, even a month or more, and then suddenly begins to 
increase. Such cases we have been inclined to explain by the 
supposition that a certain length of time was required before 
a child's digestion was equal to the new requirements, if no 
other reason could be given. We can imagine that such a 
condition could exist in a child who was artificially fed 
from the start. It should not be forgotten that growth is 
usually not a uniform, but a fitful, progression. If the weight 
is still stationary, we would suggest a food which has been 
in part already digested. As you are unable to procure 
fresh milk, perhaps Carnrick's food will be the best for 
you. For babies as young as yours we think the use of the 
bottle has advantages arising from the sucking required to 
obtain the food. 



FEEDIXG. 



(2) He does not seem to be fed too frequently at night, 
and in view of his few weeks of age and faulty nutrition, 
we should not object to his having for a time the extra meal 
he asks for. 



Unusual Hunger at Night. 

I am in considerable perplexity, and come to you with my troub- 
les, feeling assured that you can help me. My little girl is nine 
months old. When she was five months old I was obliged to supple- 
ment her natural food ; at seven months I had to wean her entirely. 
As this chauge had to be made at a season when the thermometer was 
often in the vicinity of 100°, I hardly dared give her cow's milk, and 
so fed her for two months partially, and then for two months entirely, 
on Imperial Granum, prepared with water alone. On this food she 
throve finely, and from a rather delicate-looking baby became the pic- 
ture of health. But now that she is beginning to cut teeth a change has 
come over her general health. Her bowels seem entirely out of order, 
being first very constipated, and then moving eight or ten times in the 
twenty-four hours, the movements being all unsatisfactory in quantity, 
and generally accompanied with pain. I am now giving her cow's 
milk, as I was advised to change her food on account of her digastive 
troubles. The bowels, indeed, seem improved, but there is room for 
more improvement. Although the milk she has is of superior quality 
and is given to her undiluted, sometimes even enriched with pure 
cream, it does not seem to satisfy her as the Granum gruel used to do. 
Whereas for the period between her fifth and ninth month five meals 
in the twenty-four hours were amply sufficient, and four often all that 
she would eat, she now demands a sixth, and that in the middle of the 
night. This new symptom of her waking at night troubles me a good 
deal. I can't account for it. Her custom since she was perhaps two 
months old lias been to sleep soundly all night, not waking until the 
geneva! rising-time. It seems to be hunger that wakens her, for imme- 
diately on being fed she goes to sleep. Her habits of sleeping during 
the day are still, as they always have been, good. 

I have written at this length that you might have sufficient data 
before answering the question of what I am to do about her food. 
As regards the constipation, I have a honor of physic. As regards 



NURSERY PROBLEMS. 



the hunger at night, I have a decided objection to its continuance. 
She ought to sleep from eight to six, as she used to do. 
3fandan, Dak. Perplexity. 

The sooner you rid yourself of your "horror of physic" 
the better, if you mean by "physic" the advice of a physi- 
cian. Your child may or may not need medicinal treatment, 
but that is a point you can only settle by consulting a phy- 
sician. So far as we can make out, your baby's restlessness 
and hunger are due to the same cause — namely, indigestion, 
and probably intestinal irritation of some sort. She needs 
a carefully ordered diet. Usually a child of nine months 
does not take undiluted milk of good quality, and the addi- 
tion of cream was in the wrong direction, unless water were 
added also. If food is of easy digestion, any lack of richness 
can be usually made good by greater quantity, but if it is 
so rich as to be indigestible its richness is thrown away; any 
increase in quantity only aggravates the digestive disorder, 
and, on account of imperfect nutrition, may increase hun- 
ger. 

As to a diet, beyond this general suggestion we cannot 
advise, because very many points are lacking in the descrip- 
tion upon which a physician would depend in choosing the 
particular method of feeding. 



Dr. Page's Method of Feeding. 

What do you think of Dr. Page's method of giving infants only 
three meals in twenty-four hours ? 

Meadville, Penn. Auntie. 

For a month or two an infant in health should have food 
every two or three hours; the intervals should then be grad- 
ually widened, so that by the time it is six months old it 
should be able to go four or five hours without food, and 



even longer at night, which will make in the twenty-four 
hours perhaps five meals. A young infant ought not to be 
subjected to the three meals a day of adult life any more 
than it should be given the food of adults. It is neverthe- 
less true that common practice errs in the direction of too 
frequent feeding. 



A Clear Case of Malnutrition. 

Will you please tell me what course of treatment to pursue with 
my little girl, three and a half years old, whose case I will describe? 
Until she was nine months old she was an unusually large child, but 
after that age for some time her bodily growth was at a standstill, and 
now at three and a half years she is small for her age and so thin that 
her ribs are plainly visible. Her food consists of mush and milk for 
breakfast, meat, vegetables and soup for dinner, and mush and milk 
or bread and milk, plain pudding and often fruit (stewed) for supper. 
For the last month I have been giving her maltine with pepsin and pan- 
creatine at each meal, but if she improves at all it is very slowly. She 
has been in the habit of taking an afternoon nap, but so often cried so 
long on being put to bed, that although it evidently does her good when 
she does take a nap without crying, I have been in doubt whether or 
not to continue it. 

She is a very irritable child, easily provoked, and has a habit of 
whining, and everything I use to break the habit has but little effect. 
I have thought that perhaps her want of flesh and her irritable dispo- 
sition resulted from indigestion, and used the maltine as a remedy. 
Will you please tell me if you think she is receiving the proper treat- 
ment ; if not, what do you advise ? I forgot to mention that her weight 
is twenty-five pounds. 
Stockton, Cal. < • . 11 B. 

There is certainly a lack of proper nutrition, and tins is 
in all probability due toimperfect digestion and assimilation. 

It would not lie wise to prescribe a regimen for you, because 
llii- can In' much better done by a physician who can 
see the child; hut we believe that her diet should be 



NURSERY PROBLEMS. 



made to correspond not with her actual age but with her 
period of development, which is that of a good deal 
younger child. The malt preparation is probably useful, 
and we have no doubt that a preparation of cod-liver oil 
would be much to her advantage. 



Breaking the "Bottle Habit." 

Will some kind friend tell us how to cure a child of the "bottle 
habit?" Although nearly four years of age she still clings to her 
bottle, and if we wish to spend the day or evening out, that bottle has 
togo along. Is it good for a child of that age to stick to the habit so? 
We have tried all manner of expedients without avail. 
Sancelito, Cal. Father. 

We have seen such cases of late use of the bottle. The 
habit is of no use to the child, perhaps not a positive detri- 
ment to her digestion, but it is a harm to her morale to be al- 
lowed to dictate to her parents at her age. We have known 
instances of the parents waiting until the child was old 
enough to be shamed out of the habit. But there is one 
simple way, and only one, of breaking the habit — that is to 
takeaway the bottle. It will make a trouble for twelve or 
twenty-four hours, but if the parents do not yield, simply 
preparing the food and offering it in a glass, at the end of 
that time it will be taken, sparingly, perhaps, at first, but 
presently in full quantities. This assumes, of course, that 
there is no deformity of the mouth, and that the child can 
drink water. It strengthens the resolve of yielding par- 
ents to break every bottle in the house before beginning the 
experiment. It is better not to begin than to yield. 



The Test for Changing to Solid Food. 

My baby is fourteen months old, somewhat delicate, inclined to 
rickets, with bowels disordered all summer. He was weaned early, 



FEEDIXG. 



because my older children showed similar symptoms, and the doctor 
thought, as I did, it might be partly due to the character of the milk. 
He was carefuily fed with strained oat-meal and milk, sugar of milk 
and lime-water added, till hot weather came and diarrhoea appeared, 
when the physician wished me to change to Mellin's Food, which kept 
him along till cold weather, when he picked up very rapidly. He has 
four teeth only. A recent article in the "Mother's Nursery Guide" 
says, "The appearance of double teeth is the test of changing to solid 
food." My baby is not likely to have four double teeth before he is 
twenty months old, which would bring him to another summer — not the 
time for changes. Then, again, he passes an enormous quantity of water, 
and keeps himself and his bed sopped, and it adds in no small de- 
gree to the work of caring for him, especially in the cold weather. 
This seems tome reason enough for changing to solid or semi-solid food 
if it could be done without harm to him. I must soon trust him to other 
and busy hands, and I wish to make the care of him as light as may 
be, but consistent with his best good. I should add that he takes 
nearly three pints of food in four meals in the twenty- four hours, and 
has nothing from six p. m. to seven A. m., though one might suppose 
he drank quarts. He shows no inclination to walk. 

A Dakota Mother. 

He should still be kept on liquid food, we believe. 
He takes a small amount of liquid for a child fed on 
liquid only, and will probably need three pints of 
milk for a year or two yet for the main part of his daily 
food, unless he shall have gained a previous power of eating 
solid food. We think even the inconveniences of bed wetting 
are light compared with the dangers of putting a child "in- 
clined to rickets" prematurely on solid food. 



Probable Overfeeding. 

I am an inexperienced mother, and should be very grateful for 
advice about my baby. Ever since he was born he has vomited a 
great deal. I gave up nursing him when he was three months old and 
have tried everything for him, but the vomiting still continues, to an 
almost unlimited extent. My baby grows steadily nevertheless. 



NURSERY PROBLEMS. 



Would you advise rne to keep on trying the different foods until I get 
something which seems to agree with him, or go back to the sterilized 
milk with water, a little sugar and lime-water, aud just endure the 
vomiting? It occurs from the time he has taken his bottle possibly 
until three hours after. Is it healthful or not? 

New York City. C. 

Vomiting is not healthful. Regurgitation of food, if the 
amount has been excessive, is not a sign of disease but of a 
physiological protest on the part of the stomach against 
such treatment. Just how long you have been trying to get 
a food to suit does not appear, as the age of the child at the 
time of writing is not given, and it may be that the child's 
digestion could be put right promptly by a little medical 
advice. But on general principles we may say that we do 
not approve of changing from food to food. The changes are 
not usually made for any reason except that the present one is 
not satisfactory. No attempt is made to ascertain why it 
disagrees, nor if the next would probably be better. If we 
had to try we should expect better success from a good milk 
mixture, varying the dilutions as indications arose, than 
from any series of "foods." 



Evidences of Overfeeding. 

Will you please tell me what to do for a baby that vomits after 
each nursing ? 

He is six weeks old, is perfectly well, and is growing nicely. He 
has gained a pound a week, until the past week, in which he gained 
but a half-pound. He weighs 15 pounds. He sleeps well during the 
night. After nursing he is uneasy and then vomits the milk just as he 
swallowed it. When he vomits again, sometime after, the milk is cur- 
dled. 

His bowels move two or three times in twenty-four hours. There 
are whey and curds in what he passes. I nurse him about every two 
or two and a half hours during the day and twice during the night. 



FEEDING. 



Ought a healthy child to be nursed so ? I have plenty of milk and am 
careful as to what I eat. 

Goodenow, HI. T. B. 

In all probability tbe child takes more at one time than 
his stomach can properly manage. Yon have plenty of milk; 
the baby has gained at a very unusual rate, showing that he 
appropriates a good deal of the food. At the same time he 
shows by his restlessness immediately afterwards that he is 
uncomfortable, then comes the regurgitation of uncurdled 
milk, and later, perhaps, a second regurgitation of milk 
which has been curdled by the proper action of the gastric 
juice; finally, undigested curds always exist in his bowel 
discharges. 

The giving of the breast for a shorter time at each nur- 
sing, and, if your breasts are not uncomfortable, the length- 
ening of the interval, would be the natural remedy for the 
state of affairs described. 



Feeding at Night after Weaning. 

My boy is now nine months old, and gets all his nourishment from 
the breast. I am very particular about my diet; eat oat-meal, milk, 
eggs, fruit, etc. He is nursed once in three hours, night and day. 
Shall I feed him in the night, after he is weaned, and if so, how often ? 

N. N. 

If you have not diminished the frequency of nursing 
before you begin to wean the boy, you will have quite an 
undertaking before you. For if you have to prepare food 
even- three bonis, night and day, your sleep will be badly 
broken, it may be, however, that his frequent demands for 
food are due to the fact that the breast-milk is now deficient 
In quantity or quality, so thai heisnol properly fed, and if 
be gets a full supply of food at one time he may be content 



NURSERY PROBLEMS. 



for a longer time. Try to alternate the food with the breast; 
let him take a good bottleful of the food, and then lengthen 
the interval after it. We fear that your habit of too fre- 
quent nursing will prevent your cutting him off altogether 
at night at first, but a child as old as he ought to go at least 
six hours without food at night. If he is fed at the parents' 
bed-time he ought to need no food till toward morning. 



Eating Between Meals. 

Will you be so kind as to give your opinion of children eating 
once between meals — children of the ages of three and seven ? Is it 
not necessary for their growth and strength ? 

Catskill, X. Y. YOTTKG Mother. 

"Between meals" is an elastic term, and to give our opin- 
ion any meaning we must premise that we suppose that our 
correspondent means the meals of adults, which in the 
country are usually about 7 a. M., 1- M., and *> P. M. These 
hours make the intervals certainly too long for most children 
of three years, and probably too long for one of seven. The 
"between-rneal" food, however, should be just as systemat- 
ically arranged as any other. While it comes between the 
meals of the adults, it should be a distinct meal for the 
child. That is to say, however slight the meal may be, it 
should be fixed as to time and quantity, these being deter- 
mined by the hours of the family meals and by the amount 
the child then eats. The kind of food should also be as care- 
fully looked t< > as at other meals. Promiscuous and irregular 
eating should not be allowed. Children often ask for food 
apparently to fill the gaps between games, or when no better 
amusement than eating presents itself. And the child's de- 
mands are often supplied with no greater intelligence; pieces 
of pie, residual fragments of cake, or ''whatever comes han- 



FEEDING. 



dv" iii the pantry are given to it. So far as one can judge, 
it is more frequently these irregularities than the food taken 
at meal-times that cause the frequent iudigestions of child- 
hood. When a child is old enough to have his meals with 
the adults the "betveen-meals" should be very light; a little 
milk, a cracker, or a slice of bread and butter is usually 
enough. Of course different diet is required for a child of 
three and for oue of seven. 



Ten Months' Digestion. 

Will you kindly tell me if milk, diluted with one-third barley- 
water, is enough food for a baby ten months old ? She has about 8 
ounces of food every three and a half hours. 

Also whether bread crusts to chew are good or bad for the diges- 
tion ? She is greatly troubled with flatulency, and has very hard times 
with her teeth, having only three at this age. Any advice will be 
most welcome. 
Schenectady, N. Y. A. H. 

The mixture of two-thirds of good top milk and one- 
third barley-water is probably sufficiently nutritious for a 
child of ten months. If it gets six meals per diem, it will take 
48 ouuces, of which 32 ounces, or one quart, is milk. Prob- 
ably this is enough. The bread crust, if only crust, is admis- 
sible for a child to suck. With only three teeth, your baby 
cannot really chew; any pieces which she may suck off will 
probably be digested. 



Excessive Vomiting of Food. 
I. 

Will you kindly advise me by what means I can stop my 
baby's excessive vomiting? Old-time aunties and grandmas tell me 
that all babies vomit, and that nothing is wrong with Baby, but it 
seems to me if the food is properly digested it should be retained. 



18 N URSER Y PR OBLEMS. 

I give uiy baby (nearly three mouths old), every two hours, six 
tablespoonfuls of barley-water and one teaspoonful of fresh condensed 
milk. Sometimes she seems satisfied and sometimes she does not, but 
to increase the quantity of food results in something just short of a de- 
luge. Of the six tablespoonfuls she retains about one-half. Her hab- 
its are good, and she seems to thrive, her weight being now twelve 
pounds. She weighed eight at birth. She goes to sleep every night 
before eight o'clock, and rarely wakens before 5.30 A. M. She is re- 
markably vigorous and bright, her skin a healthy color, and is in 
every respect a model baby aside from the vomiting. 

I have tried Mellin's and Carnrick's foods. Both had the effect 
of loosening the bowels, which have acted perfectly since she was 
born until the past three weeks, when there has been a slight con- 
stipation. I am away from home, and, as I cannot seek the advice 
of my physician, I turn to you for help. 
Brooklyn, X. Y. J. S. 11. 

The question presents a child of three months that has 
gained weight moderately since birth, and seems to be in 
good health except for excessive regurgitation of food. We 
are not quite sure if the other foods were likewise vomited. 
Now, while it is true that all babies may vomit, it is not 
true that all or even most babies habitually vomit; and 
when this symptom is persistent, it is usually pretty clear— 
supposing the child to be in good health — that there is 
something wrong in the quantity or quality of the food, or 
that there is some indiscretion, such as want of quiet, with 
or after the meal. Inasmuch as the total quantity given to 
your child at a meal does not seem excessive, we have to 
question whether lengthening the intervals slightly, or 
change of food would be most likely to correct the ten- 
dency. The lengthening of the interval is the simplest; this 
failing, we should be incliued to try peptonized milk. 
II. 

I come to you for help in the case of my little duughter, aged five 
months. Let me state first that medical aid has failed thus far to ben- 
efit her. Being deprived at two weeks of age of her mother's milk, 



FEEDING. 19 



the great question was to find some food that she could assimilate. 
Cow's milk with additions of lime water, Mellin's Food, barley, pep- 
tonizing powders, etc, came up in distressingly large curds. Con- 
densed milk was substituted; there was no further trouble from curds, 
and for several weeks the baby thrived, when suddenly she changed, 
her stomach seeming to reject every drop of nourishment taken, and 
her weight decreasing frightfully. My physician then gave her eream 
and water, not too rich, slightly sweetened with sugar of milk and 
strengthened with oat-meal water. The little girl is now gaining in 
strength and length (though there has been no gaining in weight in 
the past fortnight), weighs 14 pouuds and five ounces, and is the "pict- 
ure of health ;" she is very contented, and sleeps splendidly. Yet the 
trouble remains ; she seems to retain almost nothing. Her mother and 
nurse endeavor to keep her perfecty quiet after each feeding, but with- 
out avail ; the regurgitation is constant and excessive for certainly an 
hour after her meal, which consists of ten tablespoonfuls. Can you 
offer any advice ? 

E. D. H. 

This problem, while much like the preceding one, differs 
from it in some respects. In the first place, medical aid has 
been already invoked and apparently freely. We may say 
frankly that where a physician on the spot has missed the 
mark, one at a distance is not likely to hit it. But. we 
offer such suggestions as we can. We note, first of all, what 
is quite common in vomiting of the regurgitative type, that 
in spite of the seemingly excessive rejection of food a good 
deal must be retained, for the child gains in "length and 
strength," and her weight, 14£ pounds, is not bad for her age, 
live months. A second point is this: The vomiting at first 
was marked by the presence of very large curds, which were 
less when condensed milk was used, and it is so with the 
cream mixture. Now, it is probable that some difficulty in 
the digestion ofcaseine is at the bottom of the mischief . The 
food suggestion by your physician leads us to suppose that 
such was bis opinion. In such a cawe, if we were convinced 
that the regurgitation was so great that proper nutrition 



20 NURSERY PROBLEMS. 

was not obtained, we should make a food free from un- 
changed caseine for a time, which may be done by diluting 
and sweetening egg albumen, or we should perhaps make a 
careful trial of Carnrick 's Food in some quantities. I f it agrees 
it may be continued for some time. Later — as we have a 
predilection for milk foods— the change can be made to food 
prepared with some peptogenic preparation, Fairchild's for 
instance; but if the child thrives, the change need not be 
made for months. 



Baby's Temptations at the Table. 

When is a child old enough to sit at the table with its elders and 
eat of the same fare (with certain restrictions of course; I don't mean 
to include condiments), for example, hot muffins, plain cake, soups, 
fish and vegetables of various kinds ? My little girl seems to be get- 
ting tired of all the very few articles of food which she is allowed. 

A Learner. 

When we have the choice we think that a child would 
better not be exposed to the temptations of the parents' table 
untihit is two and a half or three years of age, and we should 
prefer that it be four years before it is given a general diet as 
you describe; for instance, ordinarily a muffin is hard of di- 
gestion to anyone. We know of no use for cake for children 
of any age, and vegetables vary from some of easy digestion 
to some that tax the adult stomach. 



Feeding a Premature Child. 

(1) My baby was a little seven-months baby, weighing only four 
pounds at birth, and now at five months he weighs ten pounds. Has 
he gained as much as he ought to have done under the circumstances ? 

(2) Since the third month he has been artificially fed, taking ten 
tablespoonfuls or more at a time of Nestle's food every two hours in 



FEEDIXG. 



the daytime and two or three times at night. Is he fed too much and 
too often ? 

(3) Should he be considered and treated, as regards his food, as a 
five-months or a three-months-old baby ? 

Chicago, HI. An Inexperienced Mother. 

(1) The gain seems very satisfactory, his weight being 
two-and-a-half times what it was at birth. 

(2) Probably yon could begin to widen the intervals with 
advantage. 

(3) It is not easy to say for how long and how much al- 
lowance should be made for premature birth. We think it 
safe to make an allowance, gradually diminishing, until the 
end of a year, and longer if the child is feeble. Your baby 
at five months, for instance, could be considered a four- 
months baby, at ten months, as nine-and-a-half. This, of 
course, is only approximative, and the real guide is the con- 
dition as to strength, etc., of the particular baby. 



"Sucking Wind." 

Is it possible for a baby to "suck wind" into its stomach from a 
nursing-bottle? I had always accepted it as an unquestioned fact 
until, in a recent number of a periodical, I noticed that the idea was 
ridiculed. Nurses and mothers might be relieved of considerable 
anxiety in this matter if it could be shown that "sucking wind" is 
only an "old woman's whim," as alleged by the writer of that article. 
North Dig/iton, Mass. Alice. 

There is nothing ridiculous in the supposition that a 
child may "suck wind" from a nursing-bottle improperly 
managed. Cases of air-swallowing by adults are cited in 
works on medicine. The celebrated French physiologist 
Magendie made extended researches on this point. He 
found thai many persons had the power of swallowing air, 
and he learned to do it himself, hut gave up the practice 



22 NURSERY PROBLEMS. 

owing to the distress it caused him. "Wind-sucking" is a 
familiar enough vice in horses. There is, therefore, nothing 
ridiculous in supposing that a baby with good sucking power 
might swallow air. How far infants actually do so is 
another matter; the distinction between a colic from swal- 
lowing of air and one from gaseous indigestion can only be 
made after patient watching of the symptoms. The rule 
should be: Manage the bottle so that the baby cannot get air 
from it. 



Combined Nursing and Bottle Feeding. 

Do you think nursing and bottle feeding together at the same 
meal had for a baby ? 

Clarence, Ontario. H. L. K. "W. 

We do not like it, not so much because of the mixing of 
the two kinds of nourishment, as because, if the breast is 
not equal to the total feeding, it ought to have the needed 
rest. Further, the child contracts a bad habit of wanting 
the breast with artificial food, and weaning becomes difficult. 
Still further,it is impossible to know just how much a child 
is taking when this confused method is employed. 



MILK, 



Pure versus Diluted Milk. 

Is it advisable to dilute the milk for a child of two and a half 
years? It is claimed by my wife that the milk is too rich, and that 
with a slight admixture of water it agrees better with our boy. 1 
think that since milk is his principal nourishment he ought to have it 
pure, and that if rich it is all the better on that account. 

Jeusf.yman. 

The answer depends upon the quality of the milk and 
the digestive powers of the child. A child of ordinary diges- 
tive power can take the milk — especially if warmed slightly — 
of an ordinary cow undiluted. Jersey milk, with an unusual 
an i on nt of cream, may be too heavy if pure. But it is always 
safer to err on the side of over-dilution, and to make up the 
nourishment, if necessary, by increased quantity. 



Oatmeal-Water for Dilution of Milk. 

Will you kindly tell me how oatmeal-water should be prepared ? 
Chicago, III. G. F. H. 

If you use oatmeal porridge at breakfast you can make 
oatmeal-water thus : Of the porridge take as much as you 
can lift with a tablespoon, put it into a quart of cold water 
and raise to a boil, stirring to prevent burning, and strain. 

If you do not have porridge this receipt will do: Add 
one t.il.lespoonful of line oatmeal (steam-cooked is prefer- 
able) to one pint of cold water. Stir well and strain off the 



N URS ER Y FROBL EMS. 



water. Boil the water thus strained off until it is reduced 
to about one-half in quantity. 

The water is used to dilute milk precisely as plain water 
would be. 



Proper Dilution of Condensed Milk; the Real 
Use of Lime-Water. 

Nature has deprived me of nourishment for my little one, who 
is five months old. I have given her Borden's Eagle Brand of con- 
densed milk, properly diluted with water that has been boiled, with a 
tiny pinch of salt and a little lime-water added to it. These are the 
proportions : 6 ounces boiled water, 2 teaspoonfuls of condensed milk, 
a pinch of salt, 2 teaspoonfuls of lime-water. She takes about this 
amount every three hours during the day and about half the amount 
once during the night. She weighed 7 pounds at birth, and now, at 
five months, weighs 17 pounds and seems very strong. Her only 
difficulty is constipation, which I have heard is a usual occurrence 
with bottle-fed babies. 

(1) Would you continue with the condensed milk, when she has 
gained so much, and seems so well, and I have used nothing else? If 
not, what do you recommend that is better ? 

(2) Am I using the right proportions for her age, and are 42 
ounces too much in quantity for twenty-four hours ? 

(3) Do you think any harmful results may occur from using 
lime-water in every bottle? If so, how often would you use it ? She 
never has sOur stomach, so I do not need it for that purpose, but I 
have always thought that it aided in "forming teeth." 

Yortkers. X. Y. M- v - 

(1) When a child is really doing well we do not advise 
change even if the food is not what it ought to be. Many 
children, like many adults, have sufficient digestive power 
to be nourished by imperfect food. In practice— especial- 
ly in dispensary practice— condensed milk is often the best 
food that can be obtained, and its deficiency in fat can be 
made up by using cod-liver oil, and the sugar deficiency, 



MILK. 25 



which exists if it is properly diluted, made up by adding 
sugar. 

(2) This being the ease, it is not easy to say what are 
correct proportions as regards a food which is admittedly 
imperfect. Condensed milk which is preserved and canned 
is inferior to that made by the same makers and sold in 
many cities from delivery wagons. This last is only a sub- 
stitute for good, ordinary milk whenever the latter is not 
to be easily had. We think that you dilute the condensed 
milk too much for an adequate food ; its high dilution 
makes it easily digested but not very nutritious. By increas- 
ing the strength of the mixture somewhat, from time to 
time, you can increase its nutritive power while you watch 
the digestion. If you wish to try another kind of food 
altogether, we would suggest that it be done under the advice 
of a good physician, who has looked the baby over carefully 
to see what is lacking in her nutrition. 

(3) No. Lime-water is added to milk really for this 
reason : to give to it the alkaline reaction which fresh human 
milk has. Cow's milk as sold is usually acid to the litmus 
paper, not "sour" in the popular sense. 



Peptonized Milk. 

In the directions for using Fairchild's Peptogenic Milk-Powder 
I find nowhere a recommendation to boil the milk before mixing it 
with the powder; is this not often desirable, and advisable in any 
case ? 

Two methods are described — that of " humanizing " milk fresh for 
each feeding, and that of making enough for several feedings in ad vance. 
Is there no difference between the two ? The saving of time and trouble 
is certainly on the side of the second. 

Is there any harm in the bitter taste which the milk assumes if 
heated too long or too suddenly ? 
Neio York. P. 



NURSERY PROBLEMS. 



It is better, especially in hot weather, to boil the milk 
on receipt, as it prevents or retards changes. 

We prefer the second method— i.e., that of making 
enough for several meals at one time — because if the prepar- 
ation occurs every few hours variations of heat and other 
circumstances are likely to make variation in degree of 
peptonization. Besides, six minutes seems a long time when 
the baby is crying for food, and the time is likely to be cut 
short in consequence. 

In the second method of preparation one manipulation 
may be saved by putting the mixture into a clean saucepan 
or pail, which is set into the warm-water pail (115° to 120° 
P.), and the whole covered with a " cosey " or a blanket, 
which keeps the heat uniform. The vessel containing the 
mixture can then be removed at the end of fifteen minutes, 
and the scalding done in the same vessel, and the food is 
then put into glass. A preserving-jar with air-tight glass 
top is a good receptacle for it and easily kept clean. 

It is of great assistance to use an immersion thermometer, 
which can be had for less than a dollar. 

With regard to the bitter taste we may say : First, it is 
likely to disgust the infant after a little if it is not very 
hungry, and it may refuse a part of the meal. Secondly, 
the amount of caseine in human milk and in cow's milk 
differs. There are also differences in the two milks about 
which chemists are not all agreed ; but it is in general ad- 
mitted that human milk has in it more peptone than cow's 
milk, and it is believed that partial peptonizing of cow's 
milk properly diluted approximates it to the character of 
human milk. But it would be overdoing the matter to 
entirely peptonize the cow's milk, and practically in health 
it is doubtful if it is well to feed the child on pure peptones ; 
a partially peptonized food is probably better in the long 



run. In cases of digestive trouble the peptonizing action 
may be increased. 



One Cow's Milk. 

My physician claims to be a reader of all the best and latest 
medical journals and to know all that is going on in the medical 
•world. He claims that only a few physicians favor herd's milk, and 
that all the weight of authority is on the other side. Can you give me 
names of eminent men with which to refute this claim ? It is a matter 
of some consequence to me, as he lays any disturbance of the digestive 
organs to the use of mixed milk. 

Oberlin. 0. E. R. A. 

If by " herd's milk " you mean the mixed milk of a 
herd as compared with that of a single cow, we can only say 
that we cannot recall any one, at least in America, whom 
we should call an authority, who now clings to the "one 
cow's milk " theory. Twenty-five years ago we heard it 
taught. We have taken up such recent books as are lying 
at band, but find no one in favor of one cow's milk. We 
mention two authors, because more widely known than the 
rest, who express their preference for mixed milk. Jacobi 
(article "Infant Hygiene," in Ziemssen's Cyclopaedia, XVIII, 
107); Rotch (article "Infant Feeding," in Keating's Cy- 
clopedia, I, 338). 



Top Milk. 

What is "top milk," and how much water should I use with it 
for a baby three months old '.' 

8t. Louis, Mo. W. S. S. 

"Toj) milk" is the upper half of milk which lias been 
allowed l" Stand for a time, say three hours. It should he 
dipped, nol poured, off from the under milk. For a baby 



N URSER Y PR OBL EMS. 



of three months at first add as much water as there is milk 
gradually diminish the proportion of water. 



Scum on Boiled Milk. 

Will you kindly tell me what part of the milk rises to form the 
scum on the top when boiled, and whether it should be removed or 
stirred in before feeding to a child ? 

Newtown, Conn. M. E. B. 

"We do not remember to have ever seen a chemical 
analysis of this scum, but suppose that it is chiefly the 
milk albumen and probably some fat mechanically mixed 
with it by the boiling. Whether it is to be rejected or not 
is a question of palate. Personally, we throw it out. 



A Warning against Sour Milk. 

Can you tell me what I can do when the milk sours with which I 
have to feed my eight months-old child ? My milkman comes at 
night, and on one or two occasions the milk has been sour at the two 
o'clock meal the next day. What can I give my child as a substitute 
when this occurs ? It troubles me when I try to think of what I should 
do in case of not having any milk. The milk I get is usually very 
good, and the man who brings it says the souring is caused by some 
cows going dry. Ought such milk to be used? 

Brookline, Mass. C. G. D. 

Under no circumstances should sour milk be given. 
Duriug hot weather it is better to attend to the preparing of 
food and sterilizing of milk as soon as the latter is received. 
In ease of milk souring, if sweet milk cannot be had, we 
should use condensed milk, or even water gruel, for the day, 
rather than give any doubtful milk. 



MILK. 



The Apparatus for Sterilizing. 

I -wish to try the method of feeding described by Miss Montrose in 
the " Mother's Nursery Guide," but have so far failed in my efforts to 
obtain the " patent corks " — none of the druggists here knowing any- 
thing about them. 

Will you kindly tell me where I can get all the articles necessary 
for sterilizing milk, viz., thick bottles which will bear boiling, and 
"patent corks " of rubber and glass exactly to fit them? 

A Learner. 

The best sterilizing apparatus that we yet have seen is 
that called the " Arnold." The best stopper is simply clean 
cotton, absorbent cotton being preferable. If for the purpose 
of transportation a cork is necessary, one can be prepared 
thus: Get fine corks with as few holes as possible; cut 
a long wedge-shaped piece out of the side of each reaching not 
quite to the top of the cork. The corks can be made pure 
by putting them into the chamber with the bottles while 
the steam is generated. When a bottle is taken out a 
cork may be crowded into the mouth until the slit is 
closed by the compression. Rubber corks of the same pat- 
tern are sold, and common rubber corks are excellent. They 
can I »e sterilized, after thorough washing daily. 



Bottles for Sterilizers. 

Are there no larger bottles made for the sterilizer than those that 
hold seven or eight ounces? I cannot find any in Boston. As my 
child grows older he needs more milk, and 1 should think larger 
bottles ought to be had to meet this requirement. 

Brookline, Mass. G. H. P. 

There are nursing bottles made to hold twelve ounces, but 
very few Children, if any, under a year should have more 
than ( ighi ounces at ameal. After that age it is better to teach 

the Child to drink from a cup. 



NURSER Y PROBLEMS. 



If you wish bottles only for sterilizing you can get them 
of any size at an apothecary's. Very good strong bottles are 
those used for bottled soda or beer, which, if kept clean, will 
do very well for sterilization. 



Keeping Sterilized Milk in Summer. 

Will you kindly tell uie whether you think it necessary to keep 
sterilized milk on ice during the warm weather? Our summers are 
quite severe at times, the thermometer registering from 80 to 95 
degrees in the house. I have never used the sterilized milk before in 
the warm season, and so I am ignorant as to what I should do. At 
present, I keep the bottles in as cool and breezy a window as I can 
find. The milk is thoroughly sterilized, boiling hard 45 minutes, 
and has never yet disagreed with my nine-months-old baby, who has 
taken it almost since birth. 

Macon, Ga. L. W. 

Milk which is thoroughly sterilized and thoroughly well 
corked need not be iced. In fact, so far as its sterility 
goes, it ought to stand anything so long as the bottles are 
tight. When milk is only partially sterilized or imperfectly 
corked, or in any way neglected in the preparation, of course 
this remark will not hold. 



Does Sterilized Milk Constipate? 

Are there not cases where milk sterilized will produce consti- 
pation ? 

Minneapolis. A. R. W. 

Yes, practically. That is to say, the milk, having been 
rendered unirritating by sterilization, no longer stimulates 
the bowels to the degree that raw milk does, and is constipat- 
ing in the same sense that white bread is constipating as 
compared with coarse bread. To speak more accurately, we 



MILK. 31 

should say that sterilized milk was not laxative as compared 
with uncooked milk ; and so some infants become, tempor- 
arily, at least, more constipated than before. 



A Case where Sterilizing is Unnecessary. 

My boy of eighteen months, who weighs over 26 pounds 
(without clothing), is still taking sterilized milk with his Mellin's 
Food, supplemented by a little strained oatmeal and bread and butter. 
How much longer is it desirable to sterilize the milk ? He has twelve 
teeth and seems very well. 
Aurora, X. Y. G. 

If the milk you have is of good quality, we see no reason 
for sterilizing it any longer. 



WEANING. 



Age for Weaning ; First Food ; Learning to Drink 
Milk. 

My baby boy is eigbt months old. He seems perfectly, healthy, 
with the exception of being constipated, though that trouble appears 
to be disappearing gradually. I have nursed him entirely, and 
thought of doing so until he was a year old. 

(1) Would it be better to wean him at nine or at twelve 
months ? 

(2) With what would it be best to feed him ? I thought of using 
sterilized milk, but do not know how much to give him nor how much 
to dilute it, nor whether to put in lime-water. 

(3) Would it be better to teach him to use a bottle or drink from 
a cup ? He drinks water from a cup very well now. 

(4) How soon before weaning him entirely would it be best 
to give him cow's milk to get him accustomed to it. 

Augusta, Me. A Grateful Mother. 

(1) If you have plenty of milk of good quality you may 
nurse him until twelve months. If not, you may wean at 
nine months, or at any time thereafter. 

(2) At twelve months he will probably do well on 
diluted milk, beginning with half water or, still better, bar- 
ley-water and strengthening the mixture very soon if it 
agrees with him. The lime-water would be useful but is not 
necessarily called for. 

(3) To drink from a cup. 

(4) A month probably will give him sufficient prelimin- 
ary trainiug. 



WEANING. 



A Question of Weaning before Summer. 

When should my baby be weaned ? His two older brothers were 
fall babies, and nursed ten and eleven months ; but this one came in 
May, is a plump, health}', nine-months-old boy without a tooth to be 
seen, though there are signs of their speedy coming. 

My supply of milk seems plentiful and nourishing. He eats six 
times in the twenty-four hours — once in four hours — regularly night 
and day (is that too often ?) ; and if it is best while he is teething, I 
can probably keep tolerably strong and nurse him through September, 
though it is usually quite a tax upon my strength. We shall be in 
the country during July and August, where good milk from one cow 
could be obtained. 

Have I explained to you clearly enough, so that you can advise 
which is safer for my baby ? 
Elyria, 0. M. D. M. 

It is probable from what you say that Baby already 
needs more than you can give him. At nine months six 
nursings in twenty-four hours is rather more frequent than 
is necessary, but is not excessively so. You cannot, in all 
probability, carry him on the breast alone until the end of 
September, and you would better begin to give him some 
artificial food very soon ; it is quite probable that before June 
he will have weaned himself. 



Time for Weaning; First Food. 

My baby is nine and a half months old, has two teeth, just through, 
has always been well, except an attack of tonsilitis which he nursed 
from me, and has never been fed except from the breast. He is strong, 
weighs 23 pounds, and will walk beside the chairs or push one across 
the room. He has been fed on time and not been given patent 
medicines of any kind. He nurses now only once in four or five 
hours. 

(1) Do you advise weaning him before warm weather? 



34 NURSERY PROBLEMS. 

(2) Shall I feed him some milk, diluted with water, one part to 
three? If so, how many times a day and at what hours? He nurses now 
at 8 or 9, about 1, 5 and 9, and once or twice through the night, I am 
sorry to say. 
Springfield Mass. C. B. 

(1) Yes. 

(2) One part of water to three of milk will probably agree 
at the age of eleven months, in the case of your child. Give 
at as regular hours as possible, say at 7 and 10 a.m. and 1, 4 
and 7 p.m., and a night bottle if necessary. Give food blood- 
warm, of course. 



Dropping the Night Meal. 

At what age and how can a baby best be weaned nights? If he 
wakes up and wants the bottle should he be allowed to cry ? 

Providence, R.I. A. E. R. 

At six months usually, by eight months pretty certainly, 
a child can go from, say, 10 p.m. till early morning, and 
would better do so. There is only one way to accomplish 
this. Arrange the day's meals so that the last comes at or 
about 10 p.m. Then if food is cried for give drink and get 
the child to sleep without feeding. If it will not go to sleep 
wait till considerably after its usual time before feeding, 
and each night make the hour later until your set time is 
reached. Usually two or three nights at most win the battle. 
Most of the difficulty comes from the vicious habit of feeding 
a child whenever it cries, until it comes to feel that it cannot 
become quiet without the breast or bottle, when over-feeding 
may be the real cause of the restlessno-. 



Preparing for Weaning-Time. 

My baby is just ten months old. He nurses on waking in the 
morning, at noon (when he has a nap), at half past six (when he goes 



WEAXIXG. 35 



to bed), and on waking in the evening. During the day he takes about 
a pint of milk and a slice of bread. He will not eat oatmeal. 

(1) What shall I give him when he is weaned in April ? 

(2) And how get him to sleep ? He goes to sleep nursing now. If 
he rouses in the evening and I go to him, I lie down beside him, and 
he puts his arms around my neck and goes to sleep. If the nurse has 
care of him she rocks him, or if his father, he walks with him. Neither 
of us can get him to sleep in the way the other does. He seems to 
understand perfectly what is said to him, and obeys " No, no ! " as 
well as he ever will. I should like to feed him and put him to bed 
awake. 

(3) TV ill there be any danger of his hurting himself if he cries 
quite hard at first? 

(4) Can he go from his bed-time till six in the morning without 
being fed ? 

(5) He is very anxious to walk ; is continually climbing up by 
chairs and pushing them along. But his right ankle bends in a little 
sometimes. I find also that it does not feel as large or as strong as the 
other. What can I do for it ? He weighs twenty-one pounds, has 
never been sick, but has been constipated several times from my getting 
overtired or sick. 

New Bedford, Mass. W. 

(1) If he takes a pint of milk daily and a slice of bread 
he is already well on toward weaning. The best plan will 
be to begin now to substitute warm milk and water for one 
nursing, and gradually diminish the times of nursing until 
he is entirely fed. He is at present too young to live on 
undiluted milk, and even when he is weaned we think it 
would be better to have a little water in the milk, if the 
milkman has not already saved you the trouble of watering 
it. The bread ought to be thoroughly chewed, not softened 
in milk and washed down, as the saliva should be 
thoroughly mixed with the bread to insure its digestion. 
If he lias no chewing teeth we do not think bread an advan- 
tage to him. After lie has been weaned his diet should be 
chiefly milk and cooked cereals. He may then relish even 
the disliked oatmeal. 



N URSER 7 PR OBLEMS. 



(2) The child, having been used to have some accom- 
paniment to his sleep-going, will, of course, resist any change 
in his routine. If a child falls asleep on the breast there is 
no help for it ; but the breast should never be used simply to 
put it to sleep. When the time of weaning comes you will 
have to tax your ingenuity and patience to overcome his 
habit ; but if you carry out the gradual weaning suggested, 
sucking and sleep will not be so closely associated as hitherto, 
and the problem will be by so much the easier. 

(3) Probably not. The only danger is in children who 
have a tendency to rupture. If you are in doubt, have the 
baby examined by your physician ; but usually a hearty cry 
is not dangerous, though trying to the listening parent. 

(4) Probably he can if he is not put to bed very early. If 
he is, give him food at your bed-time. 

(5) Watch the ankle and discourage the standing as much 
as you can. If he persists, get a shoe with stiff piece in the 
counter to support the ankle, and if the trouble continues 
ask medical advice. 



Systematic Weaning. 

I apply to you for advice ia regard to systematically weaning ray 
baby. She is now ten months old, well and hearty and plump, 
though having as yet no teeth. She never has been fed at all, nothing 
except water ever being put into her mouth. A chicken- bone or a crust 
of bread she often has to play with, but that can hardly be called food. 
There is still an abundant supply at "Nature's fount," but I would 
prefer to -wean her as soon as settled cool weather comes. What should 
she have to begin with, and in what quantities ? 
Buffalo, N. Y Inexperience. 

Although there are exceptions, a child can usually be 
successfully weaned with no great difficulty if the mother 
simply persists in her purpose. The infant, of course, does 



not enjoy the change, and the greatest obstacle to the wean- 
ing is the mother's natural desire to yield to the little one's 
importunities. As a contrast, it is interesting to study the 
skill with which the domestic annuals wean their young at 
the proper time. Iu the weaning the welfare of the child 
is, of course, the prime consideration, but the mother's com- 
fort should not be overlooked. For the latter reason, if the 
supply of milk be still large, the abrupt cessation of nursing 
may be undesirable, owing to the distressing filling of the 
breasts. 

It is assumed that the weather is settled and that the 
child is suffering from no ailment of moment. It will much 
simplify matters if the mother has a trustworthy assistant 
who at first can attend to the feeding, as the child will not 
then be constantly begging for the breast, and, if hungry, 
will probably take the food prepared for it. The mother 
should keep out of sight, and, if possible, out of hearing. 
The food should be given at the usual hours for nursing, and 
the quantity should be as nearly as possible the same as that 
taken from the breast. The amount taken from the breast 
at a nursing is determined by careful weighing of the child 
just before and just after a suckling. The weight gained in 
ounces represents practically the same number of fluid 
ounces of milk taken. If the amount is not known, the 
bottle may contain at first about a gill, and if it should 
prove to be not enough more can be prepared for the next 
time. The food should be freshly made each time and given 
at blood-heat. The particular kind of food must depend 
upon circumstances. Where good cow's milk can be had 
ii should be the hasis of all baby's food. As to what should 
be mixed with it, different persons naturally differ slightly. 
Our ow u preference is for barley-water to dilute it and sugar 
of milk to sweeten it. Usually two-thirds milk and one- 
third barley-water will do to begin with. As the child 



N URSER Y PR OBL EMS. 



grows older and stronger less dilution is necessary, and the 
change can be gradually made. If the child's digestion is 
delicate the milk may be peptonized with benefit, and by 
some of the methods a liquid very closely resembling hu- 
man milk may be obtained. If, however, a healthy child is 
old enough to be weaned, this precaution is rarely necessary. 
The various "foods" have their value chiefly in towns 
where absolutely good milk is hard to procure, or in excep- 
tional cases where milk is not borne well. As the child 
grows older some farinaceous food should be added to its 
milk; and we think nothing is better suited to general use 
than barley, properly prepared. 



Partial Weaning at Ten Months. 

I would like to know what is the best dietary for a baby, ten 
months old, who up to the present time has been nursed solely and is 
a strong, healthy child, with apparently not an ache or a pain ? He 
has six teeth, and seems to want to eat when he sees others eating. The 
nursing is telling on me somewhat, and I fear the child may need 
something more, he is so active. I shall be deeply indebted if you can 
tell me of some reliable infant's food to use, or give a dietary suitable 
for so small a child. I am inexperienced, as this is my first baby, and 
above all wish to avoid any experiments. 
Fort Totten, Dak. S. 

With a child of ten months, and with cool weather — 
which does not favor bowel troubles — coming on, we should 
not try a "food" at all if good milk can be obtained. He 
probably would do perfectly well if you began to give him, 
instead of one of the nursings, cow's milk and water, equal 
parts, of about the temperature of breast-milk. It need 
not be sweetened unless you chance to have sugar of milk, in 
which case a very little may be used. If it is well borne you 
may at his age quickly diminish the amount of water to 
one-quarter. Then substitute the milk mixture for two 



WEANING. 



nursingp, and soon, and in two or three months he will be 
fit for complete weaning. Do not let him eat at first, or at 
most let him suck a hard crust or a piece of roast meat or 
steak. As far as possible do not let him "see others eating," 
for if he is at the table he naturally wants, and you are nat- 
urally tempted to give him, things quite unsuitable for him. 



Dislike for Milk. 

How shall I wean a baby of thirteen months who refuses milk 
alone or with oatmeal- water ? His four teeth have white spots on 
them and little pieces crumble off. Would lime-water be good for 
him? His brother three years old has very poor teeth, caused (I 
think) by eating at one year by grandma's advice anything on the 
family table. I wish No. 2 to have better teeth if possible. 
Paducah, Ky. An Anxious Mother. 

There is no way of weaning a child who does not like to 
take artificial food except simply to wean him and meet the 
domestic disturbance which for a time will ensue. As it 
may lie that the child's dislike is not for food, but simply 
for milk and its compounds, it might be worth while to try 
a food that can be made without milk, such, for instance, as 
Carnrick's. If this is not taken, the best way would be to 
entrust the child for a few days to some other member of 
your family — if there is one— who will take entire care of 
him, while you keep out of sight, so that the child may take 
food if hungry and not be always tantalized by the sight 
of you. 

The bad teeth of the other child may be due to the 
cause assigned, i.t ., unsuitable diet, producing such a state of 
digestion and nutrition as w ill destroy the soundness of the 
various tooth structures. But the cause may be further 
back ; it may have existed at the time the teeth were form- 



40 NURSERY PROBLEMS. 



ing in the gums. Again, peculiarities of teeth are due to 
hereditary influences ; the parent's second set may be good, 
but the first set may have been a counterpart of the child's. 
We do not suppose that the minute amount of lime in 
lime-water would have any marked value. It is a useful 
drug when the stomach is acid or when the stools are loose 
and sour. 



Giving the Breast to a Child Seventeen Months 
Old. 

My baby is seventeen-and-a-half months old and has thirteen 
teeth, having recently cut a stomach-tooth. She has an eye-tooth 
nearly through and the other stomach-tooth coming. Should I wean 
her now or wait for these teeth ? She weaned herself once for three 
weeks, but when that stomach-tooth came she was pretty sick and cried 
for the breast, and has had it ever since — a month. She seems to be 
having no trouble with these teeth, and I don't know whether it is be- 
cause she is nursing or what. If I wean her now she might cry for 
the breast again when the teeth become painful, as she did before, and 
I would dislike to deprive her of her only comfort when sick; and still 
if I wait it may keep me nursing her till June. One doctor says, 
"Wean her now." Another says, "No/ she needs the nurse very 
much at such a time." I am anxious for your opinion. 

Cleveland, 0. M. W. C. 

The child ought not to have been put back upon the 

breast, for a breast so old as seventeen months is rarely of 
much use to the child, except to amuse it. The child proba- 
bly needs other nourishment. We should much prefer to 
wean such a child and to give it suitable food. It would, if 
so fed and given a proper amount of drink, in all probability 
be just as contented as with the breast. Proper medication 
will quiet the restlessness of the child better than an over- 
worked breast. 



WEAXIXG. 



Refusing to Take Food. 

I have a little daughter who will soon be one year old, and who 
weighs but nineteen pounds. All my friends exclaim at her small- 
ness, and I write to ask if you consider her so much undersized as to 
cause alarm. She seems perfectly well and fairly plump, only so 
small. I still nurse her, but fear that, while my milk is sufficient in 
quantity, it may lack in nutritive properties, so I have tried to feed 
her, but she absolutely refuses to take anything but the breast. I have 
tried milk and water, Mellin's Food and preparations of cereals, but 
cannot get spoon or bottle between her lips. She drinks nicely from a 
glass when thirsty for water, which isbutseldom. Can you advise me 
what had better be done to induce her to take food? "Would you 
starve her to it? It is not that she dislikes any particular kind of food 
but everything. She fights against medicine, whether liquid or in 
powders, in the same way, and against water unless very thirsty. I am 
worried about her size, and would be very glad if she would take food 
which would increase it. 

A Pekplexed Mamma. 

If nineteen pounds is the actual net weight of the child 
she is not very small. If her clothing was included in the 
weighing the real weight is a matter of surmise. At a year 
old she ought to be weaned, and she will, under the pressure 
of hunger, take- food. Many children, whether suckled or 
not, have the same dislike to change that she has, and will 
insist on being bottle-fed, for instance, until they are three 
years of age or older. The "absolute refusal" of an infant to 
take food amounts to little. Absolute patience and insis- 
tence on the part of the mother are sure to win. The point 
is therefore to choose a good food — good milk and water is as 
good as any for a healthy child — and adhere to it unless you 
have reasons to believe thai LI disagrees. Simple reluctance 
to lake it is not enough. You will save yourself trouble and 
anxiety if you can gel some proper person from whom this 
child will not expect breast-milk to superintend the wean- 
ing. 



DIET. 



Weight and Food at Fourteen Months. 

JIv little boy is just fourteen months old and weighs 25 pounds. 

(1) Is this sufficient weight for his age? Until eight months 
old he was very delicate, but since then he seems strong, except in 
muscular power. He can pull himself up to a sitting posture, or roll 
over and over on the floor, but neither creeps nor stands. His food 
consists of one quart of milk daily and 2 tablespoonfuls of Eidge's 
Food, with an egg for dinner. He has only five teeth through, but is 
cutting three more. Lately he has quite lost his appetite for all the solid 
food, but will drink as much as allowed. 

(2) Will it be enough nourishment if he takes only milk till his 
appetite returns? He sleeps very well, rarely waking from 6 p.m. 
till 6 a.m. 

Norwich, Eng. Ax American Mother. 

(1) Tsverity-five pounds is sufficient weight for fourteen 
mouths of age, not far from the average. 

(2) The milk will be quite enough in all probability. He 
has had the egg considerably earlier than we think is judi- 
cious for most infants of his age. 



Change from a Purely Milk Diet. 

My baby is nearly nine mouths old, and has been fed exclusively 
on a diet of top milk and water. I take the top third of the milk after 
letting it stand twenty- four hours, and at present am diluting it with 
almost half water. The milk is very pure. I do not sterilize it, and it 
seems to agree perfectly with the baby. 

(1) How soon do you think he will require other food than the 
milk? 



(2) What should be the first food given him ? 

(3) How soon would you advise me to stop using the top third 
and to give him ordinary milk undiluted ? 

He has never yet tasted anything but milk, and his digestion is 
very good. But I fear he needs some other nourishment, and do not 
know what he ought to have first. He is perfectly well, weighs 19 
pounds (without clothes), and has five bottles during the twenty-four 
hours, at 6.30, 9, 12, 3 and 6. 
Norristown, Pa. B. 

(1) He will not really require anything beyond milk 
until after the summer, but he will need a larger proportion of 
milk in the preparation. Begin to increase it gradually now. 

(2) The food can be further strengthened by the use of 
barley-water or oatmeal gruel in place of water, which 
change may be made directly. How soon he can have any 
cereal preparation thicker than gruel, and when bread crust 
and the like, depends upon the development of his teeth. 
Other things being equal, it is fair to assume that the diges- 
tive organs are proportionately developed. A child without 
chewing teeth (molars) can get little good from any solid 
food. 

(3) Ordinarily, a child of a year or a little more can 
take pure milk, if given warni. Some need slight dilution 
for some time longer, and if there is a tendency to throw up 
curds, or if they are visible iu the movements, we should 
continue to dilute the milk until the hot weather is past. 



Changing from Lacto-Preparata to Cow's Milk. 

Will you be kind enough to advise me about feeding my baby'.' 
She is now seven months old and had nothing but breast milk up to 
four months, but has had since then two bottles of Lacto-Preparata 
extra in the twenty- four hours. She has been perfectly well and strong, 
with the exception of a little constipation at times, but shows no signs 
of teetlnng yet. lam anxious to put her on sterilized cow's milk 



44 NUU.SER Y PR OB LEMS. 



soon and would like to know the proportions of milk, cream and water 
you think desirable at her age, and also if you would approve of 
strained oatmeal gruel, instead of the cream. 
Columbus, 0. Ax Anxious Mother. 

If the Laeto-Preparata agrees now we do not see any 
reason why you may not continue it for a while yet ; but if 
you prefer to go to cow's milk and oatmeal you can safely do 
so, and at the age of weaniug cream preparations are not 
necessary as a rule. If you have your own cow, and can con- 
trol your own dairy, we do not know that it is necessary to 
sterilize the milk. 



Cereals Suitable for Baby Diet. 

Could you give to us young mothers the names of cereals suitable 
for baby diet, and let us know of them under three headings — laxative, 
neutral and binding ? It would be such a help in governing Baby's 
bowels by means of the food given, and would widen the number of 
cereals with which Baby's diet is varied. 
New York. M. S. 

In our judgment there is not enough difference in the 
effects of the cereals inordinary use to justify such a classifi- 
cation. If one is to take every article that is made from 
cereals, from the finest bolted flour to the coarsest oatmeal or 
samp (coarsely broken maize), of course such a list could be 
made. But few of these cereals, however, are suitable for 
baby diet. Then, the effect of an article of a given name 
will vary considerably according to the individual prepara- 
tion. Take hominy, for instance. While occupy inga mid- 
dle place between samp and farina, it may be nearly as 
coarse as the one or nearly as fine as the other in different 
trade samples. In various ways the ordinary preparations 
are treated (or maltreated) so as to make a trade difference 
sometimes an actual nutritive one. 



DIET. 



Let us take the following table as approximately correct: 



Part per thousand. 






pq 


>> 


o 




8 


Albuminous substances. . 
Starch 


135 

569 

20 


123 
483 

27 


107 
555 

15 


90 

503 

40 

26 


79 

637 

48 

13 


51 

823 


Fat 

Salts 


5 



Balls from Graham Flour. 

Could not flour-balls be made from whole wheat flour, or rather 
from sifted Graham, which would be more laxative and more nutri- 
tious than if made from white flour ? We buy the whole wheat and 
have it ground fine, and use a great deal of it in the family. 

Claremont, X. II. R, C. 

They could be made from those flours, but, as the com- 
position of the white flour is changed by the prolonged boil- 
ing, similar changes will take place in the Graham flour, and 
if that part only which will pass through a sieve is to be used, 
the result would probably be almost indentical with the 
ordinary flour ball. There is no harm in trying it, how- 
ever. 



Graham, Oatmeal, and the Various Prepared 
Cereals. 

(1 ) What do you consider the most wholesome flour of which to 
make bread '.' What is Graham flour, and what is its value as a food, 
actual and as compared with other flours ? 

(2) What do you think of oatmeal as an article of food ? What 
is the most nutritious and palatable preparation of any grain known to 
you in a form suitable for use, say, on the breakfast-table. 

Quincy, Mass. Father. 



X USSER Y PR OB L EMS. 



(1) All things considered, we should regard a very 
finely ground wheat-meal, the best for bread for "the average 
man." Theoretically, Graham flour is such a meal; practi- 
cally, we are inclined to think some parts are removed. As 
made at bakeries, Graham bread contains bolted flour to 
dilute the Graham flour. If made at home it becomes a very 
wholesome and, to many persons, palatable bread. White 
flour has lost much of the nutrient parts of the grain and is 
very largely starch. Some persons — those of the "gouty 
diathesis," for instance — are injuriously affected by a starchy 
diet ; for such white bread is not very wholesome. 

(2) Oatmeal is very nutritious and, if well cooked, an 
excellent article of food. In our judgment, however, many 
persons more than offset its nutritive value by injurious 
amounts of syrup or sugar eaten upon it. With salt and 
milk, or cream, it is to most stomachs digestible and, to our 
taste, delicious. Meal of poor quality or badly cooked is 
detestable. It and the various forms of cracked or crushed 
wheat — the trade names are legion— which retain the entire 
grain, are the most nutritious of grain foods for the breakfast- 
table. The palatability must be judged by the eater. Occa- 
sionally oatmeal disagrees, being popularly said to be "heat 
ing," particularly to persons with a tendency to eruptions. 



Oatmeal Gruel. 
I. 
Will you inform me if you consider a thin oatmeal gruel, with a 
little milk and sugar added, a suitable food for babies ? 

Jacksonville, Fla. E. L. H. 

The age of the baby is not given; but for a child of, say, 
six months a mixture of half gruel and half boiled milk, 
with a little sugar and a trifle of salt, is usually easily diges- 



DIET. 47 



tible. If, however, there is any tendency to looseness of the 
bowels, barley-water is to be preferred. 

II. 

I have a girl-baby, eight months old, bottle-fed, who has never 
been able to digest milk. I have tried milk from six different cows ; 
have diluted it with water, and have also used it in combination with 
nearly all the baby- foods, suchasMelliu's, Ridge's, Imperial Granum, 
etc. I have for several months fed her on oatmeal gruel, made with 
water only. 

She seems to digest this pretty well, but gains very slowly, 
weighing at present but eleven and a half pounds, her weight at birth 
having been seven pounds. She seems pretty well, but cries a great 
deal, as if she was not satisfied. 

Is it possible for her to gain flesh and strength and become a 
healthy child on oatmeal gruel alone without milk, or would you 
advise me to feed milk in some form? Ihave tried usingalittle cream 
in her gruel, but it makes her more fussy. 

Weymouth, Mass, W. 

Occasionally, but rarely, we have seen children who ap- 
parently could not digest milk. When it is proved that this 
is tbe case we must make the best of it. Oatmeal gruel 
without milk is not very fattening, but it is possible to exist 
on it, as you have learned. Before abandoning all idea of 
milk we should make au attempt with cream and whey, re- 
moving the cream carefully, curdling the skimmed milk 
with rennet, and putting the clear whey and cream together 
and using them with the oatmeal gruel. This is something 
like the "Frankland Artificial Milk," which you will find 
described in the excellent little book of Dr. Jex-Blake. 



Oatmeal. 

Will you please tell me if oatmeal, soaked and then strained be- 
fore cooking, is harmful to give a baby a year old ? Does it produce 
constipation? 
Minneapolis. A. It. W. 



48 NURSERY PROBLEMS. 

If you meau that the uncooked oatmeal is to be strained 
after soaking and the liquid part— little more than oatmeal 
water — is to be given to the child, it will not do harm; cer- 
tainly it will not constipate. If you mean to give so much 
of the meal as can be squeezed or rubbed through a strainer, 
everything depends upon the coarseness of the strainer. A 
child of a year cannot digest ordinary oatmeal porridge or 
anything like it. 



Concerning the Diet of a Delicate Two-Year-old 
Child. 

Will you inform me if Graham cracker is a good food for a rather 
delicate child two years of age ? She does not care for bread or any 
kind of cracker except Graham. She likes oatmeal, but won't touch 
rice. When about five months old she was very ill with diarrhoea and 
indigestion. Her life was despaired of for days, and since then she 
has been delicate. She has only twelve teeth. She does not stand 
alone, but walks nicely, holding some one's hand. She is very pale, 
but her flesh is solid and firm. I do not give her meat, as she makes no 
attempt to chew it. She lives on milk and Graham cracker, besides 
oatmeal porridge once a day. I put thirty drops "Bush's Bovinine" in 
her milk three or four times a day; I commenced that quite recently. 
Now and then I give her mutton-broth or soft-boiled egg for dinner. 
Can she grow strong on such diet? She is a little baby, and has had 
Melliu's Food the first year and Imperial Granum the second year until 
now. Is there any preparation of lime or anything that would increase 
her strength and hasten her walking? 
St. John, X. B. K. S. N. 

The Graham cracker, if she can thoroughly chew it, is 
proper food. All the articles you are now using — namely, 
milk, porridge, cracker, "Bovinine," broth, egg — are proper, 
and she can grow strong upon them if she has enough of 
them and is able to digest fairly. The best lime preparation 
for your purpose, we think, is the hypophosphite, generally 
sold in the form of a syrup which also contains other hypo- 



DIET. 



phosphites. Several well-known makers — for instance, 
Fellows (English) and McArthur (American) — have placed 
very good preparations widely upon the market. 



The Preparation of Barley-Water. 

I want to ask your advice about the kind of food to give my baby 
who is now ten months and a half old. For the first eight months of 
his life he was troubled with constipation, and I was obliged to give 
him an enema nearly every day, but since that time I have not had to 
resort to this means more than two or three times. He seems well and 
is the personification of good nature. I shall not wean him for another 
month or two yet, but would like to know whether you wonld advise 
sterilized milk or the top-milk plan. If the latter, will you kindly 
give directions how to prepare the same, also how to prepare barley- 
water to use with sterilized milk ? I must depend upon a milkman 
for the milk, and thought on that account the sterilized would be better 
than the top-milk. My baby retires at about half-past seven and does 
not nurse more than once between that time and five o'clock the next 
morning, and sometimes does not waken between those hours. I nurse 
him every three hours during the day. He weighs 22 pounds and has 
four teeth. 

How much milk, or milk and barley-water, should he take in 
twenty-four hours? 

Elizabeth, N. J. F. A. W. 

For a child of a year it is not necessary to prepare milk 
us for a young infant. Milk diluted with barley-water will 
(b ) well enough. The milk may be sterilized if there is any 
doubt of its perfect purity and sweetness or if there is doubt 
BB t<> its keeping. 

A ^ood receipt for barley-water is this : 

Three tableafioonfuls of pearl barley. 

Three cupfuls of boiling water. 

Just enough salt to take off the "flat" taste. 

Pick over and wash the barley carefully. Cover with 
cold water and soak four hours. Put the boiling water into 



50 NURSERY PROBLEMS. 



a farina kettle, stir in the barley without draining, and cook, 
covered, for an hour and a half. Strain through coarse mus- 
lin, salt and sweeten slightly, and give when it is cool 
enough to be drunk with comfort. He will take, if he has 
an average appetite, three pints of milk and barley-water at 
a year old and will probably take more soon. The mixture 
at the beginning may be half-and-half, but presently gradu- 
ally increase the proportion of milk. 



Barley and Oatmeal Gruel. 

(1) Is not barley gruel with milk more constipating than milk 
alone with water ? 

(2) Why is it considered better to use barley gruel or oatmeal 
gruel with the cow's milk for a child with weak digestion ? 

Snoqualmie, Wash. Subscriber. 

(1) Barley gruel does not in our judgment increase the 
constipating effect, but it is less laxative than oatmeal 
gruel. 

(2) The salts contained in the gruels are useful, and 
many believe (while some disbelieve) that the gruels favor 
the formation of a finer and more digestible curd of milk on 
the stomach. 



Water for the Baby. 

My baby is three months old, perfectly healthy ; she has never 
had any water given her except in catnip-tea for colic. My physician 
says babies ought not to have water until they are eleven or twelve 
months old ; then it should be boiled. A host of "cousins and aunts" 
think I am torturing the little one by following his advice. As the 
idea is entirely new to me, and he is the only one advising the non-use 
of water, I would much like the opinion of "others in authority." 
St. Joseph, Mo. W. L. 



DIET. 51 



We emphatically believe that babies should have water 
whenever they -wish it, unless some special illness renders it 
inadvisable. The best plan is occasionally to offer Baby a 
drink of cool, not cold water. Water that has been boiled is 
safer if the water supply is not beyond suspicion. While a 
baby lives largely on liquid food, it needs, of course, relative- 
ly a small quantity of water, but on the other hand very 
many of its demands for the breast or for food are caused by 
thirst, not hunger, and would be better appeased by simple 
water. 



Harmfulness of New Bread and Cookies. 

Will you please say a convincing word to mothers against the use 
of new bread and cookies for the little ones ? I know many a mother, 
so careful lest her child get wet or "take cold," who yet destroys diges- 
tion by the use of these two articles of diet ; and by no means is it the 
uneducated mother alone who thinks, as one said to me, that "fresh 
bread is good enough for any one. " I suppose that new bread and pies 
have made us the nation of dyspeptics that we are, more than climate 
or work. 

Northboro, Mass. E. T. A. 

We doubt if we can say a "convincing word," for we 
believe the habit of giving children such things comes not 
from ignorance, but from that lazy amiability which prefers 
to gratify them at the moment rather than to deny them 
anything at the cost of some self-denial and perhaps tran- 
sient trouble. We can hardly imagine intelligent persons 
really suppose these things good for children, but they 
simply follow their natural benl and deny the harmfulness 
of any course they like to pursue. 



NURSERY PROBLEMS 



A Varied Bill of Fare. 

Is it advisable to give a baby almost fourteen months old much fruit? 
Our baby has been troubled with constipation, and, not wishing to give 
him medicine, we try to give him such food as will help his trouble. 
Please suggest some food or simple remedy for that complaint. He 
takes for breakfast a soft-boiled egg ; in a couple of hours we give him 
half-an-orange ; for dinner he eats rice either in mutton or beef broth; 
in the afternoon he gets a baked apple, and for supper oatmeal gruel 
or potato and milk. He does not care to drink milk, but I have not 
weaned him at night yet. He is very fond of fruit ; it seems to agree 
with him, and he has been taking the orange and apple for the past 
month. We often give him a rare piece of beef to suck or chew, but 
do not allow him to swallow any, and occasionally he takes bread and 
milk. Now, have any of the kinds of food mentioned a tendency 
to add to his trouble ? I have given him corn-starch for a change, but 
does a child at that age require a change and variety of food ? Is it 
probable that he would get tired of the same thing for his dinner every 
day ? Would stewed prunes be good for his complaint? 

Pittsburgh, Pa. B. B. 

Of course fruit must be given with some care to bo 
young a child. Your baby, however, does not show any 
sigus of getting too much; at least none are apparent from 
your account. 

The causes of constipation are various, and a few min- 
utes' conversation with your own physician after he has 
seen your little one will give you more information really 
useful to you than any attempts we could make at a distance. 
His diet seems to us much more mixed than is needful for a 
child of his age; probably if the rice, potato, and the corn- 
starch were omitted, and the oatmeal gruel increased pro- 
portionately, the constipation would be somewhat relieved. 
But, we repeat, your family physician would be the better 
adviser. Probably you overrate the necessity for change and 
variety of food. It is easy to educate a child into such a 
state of fussiness, that, to use a country phrase, it is con- 
stantly "cake-hungry but not bread-hungry.'' If a child is 






DIET. 53 

really weary of a certain kind of food, you may trust him 
to show it in an unmistakable manner. 



Flesh-Forming Food. 

Can you give me any information as to the best flesh-forming food 
for bottle-fed babies? 

Greenwood, Miss. W. P. 

We can only say that the "best food, obtainable every- 
where, is probably pure milk, properly diluted, to suit the 
age of the child, with barley-water. If the child is ill it may 
need special kinds of food. 



Broth. 



Would you give a child a year old mutton or chicken broth once 
a day, and ought this to be thickened ? If so, with what ? 
Minneapolis, Minn. A. R. W. 

The broths are quite admissible, with a little rice or bar- 
ley well cooked in them, but it is not necessary to give them 
daily. Nor are they absolutely necessary at all. 



Meat-Sucking. 

When is it advisable to give a young child a piece of beef to suck ? 
Riverside, X. J. E. M. W. 

Unless suckling is unduly prolonged, we see no reason 
for giving any solid food before weaning. A chicken bone or 
a chop bone, it being made certain that there are no loose 
pieces of bone which may be sucked off and swallowed, is 
sometimes admissible to be chewed upon, more as a substi- 
tute for u teething-ring than for nutriment. The giving of a 



54 NURSERY PROBLEMS. 

piece of beef to suck is open to the objection that one cannot 
know how much or how large pieces of the beef will be swal- 
lowed; therefore our personal preference is not to give the 
beef until we are willing it should be eaten. This, of course, 
is after the first year, and often as late as the middle of the 
second year. 

A Chicken-Bone. 

My husband and I have just suspended — not finished — a hot dis- 
cussion as to the propriety of letting our baby, age six months, suck 
a chicken-bone. He had ten arguments against my one in favor of 
it, which is that my mother always let her babies do it, and is it likely 
that if she could see no harm in a nice, well-polished drum-stick, my 
"John," who knows nothing of the management of infants except from 
books, has reason on his side? He quotes the "Mother's Nursery 
Guide" as having said that the food of an infant should be milk, and 
perhaps cereals, for the first year. I don't call clean chicken-bones 
"food," and mother says children get lots of comfort out of them. 

Baltimore. Clara S. 

P. S. Baby liked it ! 

Without doubt; and she would have liked still better a 
cup of chicken-soup, a bit of fat, salt pork, or a stick of 
candy. If she has no teeth that might disengage a bone- 
splinter, and there are no adherent bits of gristle or meat- 
fibre on the "nice, well-polished bone," it might not harm 
her more than would an ivory ring or stick. Give the pre- 
ference to the latter when she craves something to rub on 
her itching gums, for she will not grease frock and hands 
with it. The desire to put what the old woman used to call 
" something tasty " into babies' mouths seems to be well- 
nigh incorrigible with inexperienced mothers. Depend 
upon it, "John " does not err in objecting to experiments in 
this direction. In nineteen cases out of twenty they are 
harmful rather than beneficial, and the twentieth instance 
is usually a negative advantage — a thing that does neither 
harm nor good. 



DIET. 55 

Mutton Broth in Addition to the Bottle. 

My baby, fifteen months old, is a hearty, healthy child, but is not 
growing as rapidly as I should like, weighing but nineteen and a half 
pounds. I give her a bottle — using the gelatine and arrowroot food — 
when she first wakes, between six and seven, another after her bath 
about 9.15, another at one, another at five, and one before she goes to 
bed, about 7.30. Thinking her old enough now for a more varied diet, 
I have of late been giving her mutton broth with rice in it, but am un- 
decided ichen to give it. To give it in addition to her bottles — that is, be- 
tween any two of them — will, lam afraid, do more harm than good 
by burdening her digestive organs with more work than they can pro- 
perly attend to, as I think she has already a sufficient number of meals 
a day. Do you think it would be wise to omit the one o'clock bottle, 
giving her instead as much mutton or beef broth (she usually takes 
about three-quarters of a cupful) as she will take ? Is this too rich to 
give her every day ? How would it be to alternate the broth with oat- 
meal and milk, etc., or do you advise me to continue the milk diet 
alone, resting content with good health and happy spirits? 
Princeton, X. J. J. S. 

If the child has " good health and happy spirits " there 
is no evident reason for change at all. But you have worked 
out a very good plan for yourself. If you would like to try 
the mutton broth it should be given in place of & bottle, and 
the one o'clock hour is the best one for replacing. Our own 
preference, however, would be for the oatmeal and milk 
(gruel) for the noon meal, if it is found to agree with the child. 



Butter and Eggs. 

1 

I have a little motherless girl of two-and-one-half years, and I 
would very much like to have your views regarding butter and eggs as 
a regular diet for her. She has had added to her hominy-and-milk a 
little cream, also a little cream to her milk for breakfast. After the 
hominy sin- has bad a soft-boiled egg, topping off with bread and but- 
ter. She has just had a bilious attack, vomiting at intervals for some 



N I TRS ERY PROBL EMS. 



hours. She threw off considerable bile. Finally, after a sufficient 
lapse of time, a mixture of bismuth was given to her, when she went 
to bed and slept soundly throughout the night, and was "as bright as 
a button" in the morning, and is all right now. "What I wish to avoid 
is a repetition of the attack. What, then, is your opinion of butter, in 
the first place, if given liberally to children, and what do you think of 
a soft-boiled egg every morning as part of Baby's breakfast ? My lit- 
tle one has a delicate frame and digestion, but is perfectly well and 
healthy. 

New York. S. G. 

Butter in moderation is usually advantageous as being 
an easily assimilated animal fat. But it would seem that you 
have given it to your little girl without moderation. Thus : 
she had it in the milk on her hominy ; she had more in the 
added cream, again in the milk she drank and in the second 
added cream, and then she "topped off" with more on her 
bread. Probably, altogether, she got at least as much as a 
man of strong digestion would take for his breakfast. It 
does not seem necessary to add cream to good milk — indeed, 
usually it is injudicious, and a child who uses much good 
milk does not need additional butter. 

The fresh egg also is usually well borne, and probably 
will be again if you moderate the amount of fat you give 
with it. Try hominy, milk, and the egg. If you have 
trouble then, give the egg on alternate days, limiting the 
amount of milk at that meal. 

The fact that your little one has a delicate digestion 
should render you careful, and she may be one of those per- 
sons (who are not so common as is supposed) with whom 
eggs do not agree; but before believing this, try the above 
suggestions. 

II 

(1) Do you advocate the use of soft-boiled eggs for babies a year- 
and-a-half old? (2) Are they constipating, and (3) could one be 
given every day if they seemed to agree ? (4) At what age should a 



DIET. 57 

child begin to eat butter on bread ? My baby-girl, who is nearly 
seventeen months old, has never tasted it. Two or three of my friends 
are in the habit of giving it to still younger children. 
Brooklyn, X. Y. M. M. 

(1) The egg is permissible, but its use should be watched, 
to see if it agrees. 

(2) Not usually. 

(3) Yes. 

(4) When its teeth enable it to chew the bread thorough- 
ly. If the child takes much milk the butter is not necessary, 
but a small quantity is not harmful. 



Bone-Producing Food. 

Can you recommend any food to be given either with or in place 
of the condensed milk as a bone-producer? 

New York City. C. S. Y. 

No food is, in our judgment, a "bone producer" except 
as all properly constituted food that is easily digested is. 
Foods may be deficient in salts or in nutritive matter, and 
may not form bone in the same sense that they do not form 
flesh or blood. But good nutritious food will meet all the 
demands. 



Potatoes. 
Kindly tell me what you consider the diet should be of a child of 
two years, with sixteen teeth, a good digestion, and an extremely good 
appetite ? Do you think potatoes too starchy for a child of his age? I 
mean boiled, baked or stewed. My little boy is very fond of them, 
but my physician told ine that potatoes were something a child should 
eat but seldom. I had always supposed before that they were nutri- 
tious and extremely easy to digest. I shall be very much obliged if 
you will tell me what you think of them as an article of food for 
children. 

Chicago, III. H. T. S. 



NURSERY PROBLEMS. 



The physician is right about the potato in general. At 
two years we admit the baked or roasted potato (not boiled 
or stewed), lightly broken up and salted, not matted down 
with butter. Put what butter the child needs on his bread. 
But this potato, even when carefully prepared, we watch as 
a "suspicious character" to see if it really is well digested. 

A child of two years needs four meals: the first at about 
7.30; the second at 11 a.m.; the third about 1.30; the fourth, 
at 5.30 p. m. The first meal should be of milk, bread and but- 
ter, and perhaps well-cooked oatmeal or wheaten grits ; the 
second meal, milk and bread; the third, meat (beef, mutton 
or chicken cut very fine or scraped), broth — or instead baked 
potato if permitted — and a light dessert, such as a tablespoon- 
ful of simple custard, boiled or baked, or the rennet curd 
called "junket" or "slip;" the fourth meal, bread and milk 
only. 



Tomatoes at Three Years. 

Are nice ripe tomatoes injurious to children three years old? 
Rhode Island. W. 

We do not think that many children of three would be 
benefited by the use of tomatoes. Some children seem to 
have the digestive omnipotence of the ostrich, but the rule 
is the other way. The acidity of the tomato makes it unde- 
sirable as a part of the dietary at an age when the bulk of 
the nutriment must come from milk. 



Amount of Fruit for a Child of Two Years. 

Your judgment would be esteemed a favor in answer to the follow- 
ing question. Are two oranges and two apples too much fruit for a 
child two-and-a-half years old to eat in a day? 

New York City. X. X. 



DIET. 59 

A categorical answer cannot be given. Two oranges 
make rather a large helping, but if not very large ones and 
properly prepared, given as part of a breakfast, or at a fixed 
time in the morning so as not to spoil the next meal, are 
probably harmless, unless there is some sign of speedy indi- 
gestion — i. t . within a day or two. Many children cannot eat 
them at all safely. Apples are usually to be given cautiously 
to children so young. It is a fruit that should be well 
chewed, and little folks are not as a rule good and careful 
chewers. With some persons they create no disturbance, 
but with many, especially those with a tendency to flatulent 
indigestion, they are very hard of digestion. If your child 
has for a considerable time taken the amount of fruit indi- 
cated without bad results, we* must assume that it has 
unusual power for digesting such things. If fruit is given 
for a laxative purpose, the problem is different; baked apples 
then become not so much an article of nutrition as a medi- 
cine. On the average a child of two-and-a-half years should 
be restricted to say half of a good-sized apple, pared and 
cored. 



Cocoa. 



Is cocoa a good breakfast drink for young children ? 
Leaman Place, Pa. A. C. B. 

By cocoa, we understand an unadulterated preparation of 
the roasted nut of good quality. There are all sorts of prep- 
arations <n the market, varying from the costly chocolate 
down t<> the husks or shells, not to mention adulterated or 
spurious articles. For a young child the addition to milk of 
a Substance rich in fat and nitrogenous substances— as is 
really good cocoa— makes a mixture in our judgment usually 
too rich, nnkss it be understood to be a food and not a 



NUBSERT PROBLEMS. 



drink. Chocolate and bread would make a meal, if the 
power of digesting fat is good. The multitude of prepara- 
tions of cocoa from which the fat has been more or less 
removed we do not discuss, as it would require a knowledge 
of each preparation. 



Honey and Molasses. 

What is your opinion of honey and the ordinary brands of mo- 
lasses as a part of the dietary of children ? 
Lake Valley, N. M. A. P. H. 

Honey is a mixture of several sugars and of other things. 
For some reason it often disagrees, and persons of good 
digestive power not infrequently suffer violent attacks of 
indigestion from it. If it agrees it may be used under the 
same restrictions as other sweets. Concerning molasses our 
opinion, as an article of food, is the same as concerning 
sugar. It has the advantage that it may be added to food as 
a laxative when one is necessary, but it is inferior to some 
fruits, if they are obtainable. 



Pop-Corn. 

"Will you please say whether pop-corn is good or healthful for 
children between the ages of three and eight? 

A. S. 

There is a long gap in digestive ability between the years 
three and eight. Pop-corn eaten at a meal, and well 
chewed, although not a desirable food, may be borne well by 
many children of eight. We should not think of giving it 
to those of three. But there remains the objection that 
children do not eat pop-corn at meals, but at other times 
when they should not eat anything. 



DIET. 61 



Fruit and Milk. 

How much is there in the popular idea that milk and fruit do not 
go well together? My little ones are inclined to constipation, so they 
need all the fruit they can digest ; but they must either go without 
milk, which is one of their chief articles of diet, or eat the fruit at their 
meals with their milk, or eat the fruit between meals, which seems to 
me a bad habit to establish. Which of the three ways is best? 
Canton, 0. C. W. E. 

The incompatibility varies with different fruits and with 
different digestions. So far as a general rule can be given, 
it is this : You know that many fruits — baked apples, 
peaches, berries — are habitually served with cream, said 
"cream" being as often as not only top-milk. Very acid or 
unripe fruits do seem sometimes to disturb the digestion of 
milk. Ripe, sweet fruits generally do not have this effect, 
and may be given, if the child is old enough to have fruit, 
irrespective of milk. One reason, it seems to us, that milk 
and fruit disagree is this : They are eaten together, and 
whole berries, perhaps, with tough skins, or unchewed 
pieces of larger fruit, are washed down and cannot be readily 
attacked by the digestive juices. We have supposed that 
the indigestion sometimes following huckleberries and milk, 
for iustance, was due to this fact, and would not have 
occurred if the berries had been served dry and the child 
obliged to chew them well, the milk being swallowed later 
in the meal, in giving fruit to children the pareut must 
carefully select for each child what it is to eat, and see that 
it is properly prepared. Cooked fruit and milk rarely dis- 
agree — the traditional baked apple and milk, for instance. 

The habit of giving fruit between meals is not bad if the 
fruit hour is fixed and it is made a meal. This may be on 
rising -which, when constipation exists, is a very good 
rime or it may be bet w cen breakfast and the mid-day meal. 
To young children we prefer not to give uncooked food after 
the latter meal. 



NURSERY PROBLEMS. 



can 



A Bill of Fare for a Two-Year-Old. 

I am in the greatest distress about preparing meals for my child 
two years of age. Will you please inform me what articles of food cai 
be allowed a child of that age, and also what would be proper for din- 
ner, what for supper and what for breakfast ? She refuses milk-toast, 
rice and beef broth, and eats so little that I ask you to name some 
varieties that might tempt her appetite. 

Roxbunj, Mass. C - S " 

We cannot tell you all the things that a child may have 
at two years of age, but we shall probably best give you the 
necessary hints by placing before you two dietaries which we 
have endorsed. The two may be given alternately, or either 
daily or for longer periods each. 
No. 1. 

FIRST MEAL — 7.30 A. M. 

Cup of milk. Slice of stale bread or cracker. 

SECOND MEAL — 11 A. M. 

Bread and milk. 
third meal— 1.30 p. M. (later if the midday nap requires it). 

Thin slice of rare roast beef, mutton, or white meat of 
chicken, cut very fine, or, better, scraped; roasted potato with 
"platter gravy." (This may be indigestible for some child- 
reD , but many eat it without harm.) Dessert spoonful of ice 
cream (plainest). 

FOURTH MEAL — 5.30 P. M. 

Bread and milk. 

No. 2. 

FIRST MEAL. 

Tablespoonful of well-cooked oatmeal or wheaten grits, 
saucerful of milk, slice of bread and butter. 

SECOND MEAL. 

Bread and milk. 



DIET. 63 

THIRD MEAL. 

Beef or chicken broth, cupful, with bread. Small piece 
of broiled fish or mutton chop. (Exercise great care in choos- 
ing fish, and in warm weather, except at the sea-side, they 
are better omitted.) Tablespoonful of plain custard, cup of 
milk. 

FOURTH MEAL. 

Bread and milk. 

These will suggest to you various modifications applica- 
ble to your child's case. 



Strawberries at Four Years. 

r would like to know through your columns what you think of 
strawberries for a child of four years? 
Randolph, Mass. J. C. 

There is no fruit about which there is so much un- 
certaiuty as the strawberry, owing to the quite common 
idiosyncrasy which makes its possessor unable to eat the 
strawberry (as well as some other things) without severe in- 
digestion or an attack of hives ( urticaria. ) Nevertheless, if 
experiment reveals no such peculiarity, we believe straw- 
berries admissible at the age you mention, provided they are 
fully ripe and fresh, that they are taken early in the day or 
at noon, and do not form a part of the same meal as milk. 
Good berries, ripe enough to eat, need but little if any sugar 
(how good the old hillside berry was without any!), and 
taken with a biscuit or a slice of bread, the quantity 
moderate, make a proper part of the midday meal, or may 
form l lie forenoon hinrheon usually needed by the four-year- 
old. 



64 NURSERY PROBLEMS. 



Ripe Water-Melon. 

What do you think of giving, with care, to a child of twenty- eight 
months ripe water-melon fresh from the garden? The child has his 
full set of first teeth, and is in perfect health, and, since he appears to 
crave melon more than any other one article of diet, it is hard to deny 
him. 
Dighton, Kans Constant Reader. 

A child with a full set of teeth might digest fresh and 
fully ripe water-melon "given with care." The teeth, of 
course, are not needed for eating the melon, hut the posses- 
sion of a full set suggests a certain degree of maturity of the 
digestive organs. It should, however, be always given both 
fully ripe and very fresh and moderately cool, and its effect 
watched before repetition, because of individual peculiarities 
about the digestion of apparently harmless articles. 



Figs at Thirty Months. 

May I trespass on your kindness to tell me a little about the value 
of figs as a diet for babies ? My little girl of two and a half years is 
so inordinately fond of them that from rising uutil bed-time "pig, pig, 
please ma," is ever on her lips. Heretofore I have given her one on 
getting up at 7 a. M., two or three halves during the day, with possi- 
bly a half on going to bed at 7 p. St., rarely in excess of this. I have 
now ceased giving her any, as I fancy she seems less bright, and less 
buoyant; and knowing no cause, think that perhaps the figs may lie 
at the bottom of the trouble. I buy the best in the market, and am 
very careful to cut away any portion that is dark of color. 

I have read that if you view a fig — even the newest — through a 
microscope of medium power, it will b3 seen to be alive with animal- 
cule life. Is it so ? And if so, is it wise to use them for food ? 
Minneapolis, Minn. G. B. "W. 

The fig is not very valuable as a diet strictly speaking. 
It i- an admissible luxury in season and in case of constipa- 
tion a useful laxative. Our feeling is that fruit should 



DIET. 65 

always be given (as, indeed, all other food) at meals only. 
If you see fit to make a supernumerary meal, it should be at 
an established hour. The habit of allowing children to eat 
at irregular times, i. e., between meals, we hold to be dis- 
tinctly pernicious. As to your little one, if you wish to 
gratify her liking for figs, we would suggest that they be 
given at the end of breakfast, aDd at the end of her midday 
meal, which we suppose is somewhere from noon to 2 p. m., 
but not at night. 

We do not know whether good figs usually have living 
organisms recognizable by low powers or not. But even if 
it be so, we do kuow that the danger of minute organism 
depends entirely upon their kind. For example, most ice 
contains bacteria, but disease does not usually result from 
its moderate use. The fact that in all ages figs have been an 
acceptable article of diet sufficiently shows their wholesome- 
ness, for adults at least. 



Oranges for Infants. 

Would you kindly say how many oranges a child eighteen months 
old may he allowed to eat a day without danger of injuring health? 

How young a child may be safely allowed to have the juice of one 
orange a day? 

Would three oranges a day have an injurious effect on the quality 
ot a child's teeth during dentition? 
Boonton, X. J. C. A. N. 

These questions cannot be answered categorically. No 
One unacquainted with the child can tell how much of orange 
oi any other food can be borne by any particular child with- 
out d.tnger. Ordinarily we do not give oranges as early as 
eighteen months, and we should suppose that the average 
child of thai age would have quite enough if it ate one 
daily. To very young children we know of no reason for 



JSTURSERY PROBLEMS. 



giving oranges at all, except as a laxative, or as an indul- 
gence just as they are given candy. 

We do not know that any one has ever studied the effect 
of orange juice on the progress of dentition. But we should 
not wish to have a child whose diet is— or should be— largely 
milk, take any such amount of vegetable acid into the 
stomach at any time while the milk was there. 



Ice Cream. 

Do you consider vanilla ice cream injurious to children abovethree 
years of age, if given in small quantities and eaten slowly ? 
Leaman Place, Pa. A Mother. 

To this question an explicit answer cannot be given. In 
the first place simple ice cream (not the stupendous concoc- 
tions of the confectioner, but a simple mixture of cream and 
sugar, with flavor, frozen), in moderate quantity, would seem 
to be as inoffensive as any sweet that could be devised. But 
whether or not it is so depends upon several things. First 
of all the same cream which eaten slowly (small pieces being 
allowed to melt in the mouth) would be harmless, would 
help to set up an indigestion if large pieces were allowed to 
go to the stomach while very cold. 

But in our judgment a great distinction is to be made 
between those who can and those who cannot eat sweets. 
We know that there is a very large class of people who can- 
not safely eat much of certain things (sweets, starchy food, 
including bread, potatoes and many others seemingly harm- 
less), without sooner or later suffering for it in some way. 
This group of persons are called the gouty. They are rela- 
tively more abundant among the head workers than the 
hand workers. The offspring of such persons early show 
this inability to properly dispose of sweets, and to such 
children even ice cream is not harmless. 



DIET. 67 



It is a natural desire to give pleasure to our children in 
simple gratifications of their palate, aud the rule we give to 
those asking advice is: See that the ice cream is of the 
really simple kind; give it in small doses at rare intervals, 
say at Sunday dinner or some other easily remembered 
time; watch to see if the next two or three days are as free 
from indigestion or from fretfulness as other days, and from 
other evidences of disorder. We speak at length regarding 
the ice cream because this involves the whole principle of 
sweet eating. 



A Salt-Embezzler of Three Summers. 

I would like very much to know your opinion in regard to one or 
two things concerning my little girl, three years old. She is appar- 
ently healthy, but I am very careful about her diet. I suppose you 
will think my questions foolish, but I feel ignorant and am anxious to 
be enlightened. 

She is very fond of common table salt. I am sometimes obliged to 
punish her to keep her from eating it in great quantities. Is it in- 
j urious? 

Is sage- tea ever beneficial? Are nuts hurtful? 
Manson, Iowa. E. A. It. 

Your questions are far from "foolish." A good deal of 
salt may be eaten without harm except the exciting of 
thirst. Just what quantity is harmful in any given ease 
cannot be definitely stated. The best way is to give the 
child a liberal allowance and not allow her to take it herself. 
Keep run of the amount and watch for symptoms, and if 
you find any that you think probably due to the "use of the 
-ah diminish the quantity. The exact amount meant by 
"greal quantities," of course, we do not know, hut the taste 
:ind desires of differeni adults vary greatly, and there is no 

reason why i hose of children should not. 



NURSERY PROBLEMS. 



Sage-tea is sometimes of use medicinally. It Mas 
anciently held in high esteem, but is now chiefly used in 
d< ►mestic medicine. It makes a good gargle, especially with 
the addition of alum and honey. It is also useful as a tonic 
to the stomach when there is flatulence, and sometimes 
allays nausea. Made weak it is a grateful drink to many 
persons in fever. 

Nuts are often hurtful by reason of their indigestibility. 
They should, if possible be kept out of the way of young 
children. 



Summer Problems. 

[ wish to ask for advice concerning my little boy, who will be a 
year old next month. He is a small baby, weighing about fourteen 
pounds, but, as he is plump and well, the light weight causes no alarm, 
He has two teeth, with the prospect of more very soon, and sleeps well. 

He has taken Mellin's food since five months old. His digestion 
is good. He has 33 ounces of milk and 4 ounces of water, with seven 
large tablespoonfuls of Mellin's, in twenty-four hours, having about 
seven and a half ounces every four hours between 6 a. m. and 6 p. M., 
and at my bedtime. 

(1) Would you advise giving the same food all summer until cool 
weather, and, if not, what changes do you advise? 

(2) Will it be necessary to heat the milk during the summer? 
If so, what coutrivance would be best to take with me to the country 
for heating purposes? 

(3) Does the presence of Mellin's food render the milk less liable 
to changes caused by atmospheric conditions, as thunder-storms, etc.? 

(4) When shall I discontinue the 10 p. M. feeding? If advisable, 
I would prefer to do so before taking him among strangers. 

New York City. s - 

(1) It seems to agree and probably will do B3 through 
the summer. He may need larger meals. 

(2) It should, we think, be made blood-warm for some 
time to come. A common oil-stove lamp is most economi- 



DIE T. 69 

cal. Alcohol lamps are tidier. Immersing the bottle in a 
vessel of hot water is a good way, if you have kitchen privi- 
leges. 

(3) We think not. The electricity in thunderstorms will 
not affect milk of itself. Certain bacteria are more active 
(apparently) in weather which favors thunderstorms; but a 
well-corked bottle of sterilized milk, or any thoroughly 
sterilized food, will not be affected. 

(4) He will need an evening meal for some time yet, 
but that meal may be made earlier than it is now given, if 
you prefer. 



Bananas, Apples, and Oranges. 

Should a healthy boy twenty-two months old eat half a banana at 
a time, or any banana at all ? And if not, why not? He has been 
given a quarter of an apple at once and part of an orange, and some- 
times grapes, with, of course, skins and seeds always removed. These 
three last fruits he has had for a number of months past. 

West Newton, Mass. G. W. S. 

He should have no banana at all. Only the most ac- 
complished masticator can do anything with the tenacious 
pulp. It is palatable, but even for adult use it should be 
either very thinly sliced or scraped up. In our judgment it 
is a hazardous experiment to give this fruit to any child 
who is not at least five years of age. The apple is not ad- 
visable, but if you scrape the pulp very finely it may be 
given if constipation demands it; otherwise wait. The 
orange, carefully divested of seeds and of the fibrous part 
(best accomplished by cutting theorange across and feeding 
with a spoon what you wish to give the child), will prob- 
ably do no harm; tbe grapes, perhaps, are also admissible if 
carefully prepared, but in hot weather they would better be 
omitted. A child of the age mentioned should not be 
allowed to feci itself with fruit. 



70 NURSERY PROBLEMS. 



The Abuse of Sugar. 

Should sugar be a constant ingredient in the simple food (bread 
and milk, rice and milk, etc.) given to a child under two years of age? 
One hears that too much of it causes digestive disturbances. Is it nec- 
cessary for the child to have any? 

Ithaca, JV. Y. E - 

In our opinion, after a child is old enough to eat rice or 
bread, sugar is not needed at all. If it can properly 
digest these articles of food it can, from their starchy con- 
stituents, manufacture enough sugar for its needs. We 
think it far better to teach the child to take its bread and 
milk or rice and milk with a proper seasoning of salt, and 
without any sugar at all. To add sugar is only to tickle the 
palate at the risk of the digestion and general health. 



Vegetables. 

(1) Is boiled celery more easily digested than when uncooked? 

(2) Is not the raw tomato easy to digest if given with only a 
sprinkle of salt? My children enjoy it so, and I had supposed it plainer 
than when stewed, as the acid seems less strong. 

(3) Are tomatoes, when stewed with milk, suitable for children, 
about half a cup of milk being used to a pint of cooked tomatoes? 

(4) Do not dried split peas, stewed with butter and salt, contain 
considerable nutriment ; are they difficult of digestion? 

(5) At what age may beets be given, if well boiled? 

((3) Ought not a child of eight years to be able to digest a small 
quantity of parsnips, onions, carrots, etc., at dinner time? Of course 
only one variety at a meal. 

(7) Is cabbage admissible at this age, and is not raw cabbage, 
with slat, more easy of digestion than boiled? The child is strong and 
well. 

Leaman Place, Pa. A. C. B. 

(1) Yes. Uncooked celery is considered not very di- 
gestible, but in an adult's dietary it forms so small a part of 



DIET. 71 



a meal that it counts for little. To a child of three or four 
a siugle tender slip, uncooked, may be allowed occasionally 
at the midday meal. 

(2) We do not think the raw tomato as digestible as the 
cooked. If in any particular case — as of your children — 
you have found by experiment that the raw fruit does not 
disagree, there is no reason why it should be refused. 

(3) Not for very young children ordinarily. Children of 
three-and-a-half to four may take them at midday, the 
effects being noted in each case and the continuance of their 
use being governed by these effects. 

i 4 > They contain a good deal of nutriment ; they re- 
semble the cereals, but have more nitrogen and little fat. 
If the peas are thoroughly cooked until quite soft they are 
usually digestible to a child who chews well. 

(5) Beets require so much cooking that we generally do 
not admit them to the dietary of young children. If very 
thoroughly cooked and finely cut up, probably at fiveor six 
years they can be digested. 

(6) Perhaps ; it will depend upon the bringing up, the 
natural strength aud the peculiarity of the individual's diges- 
tive powers. The vegetables mentioned, particularly the first 
aud third, need to be very well cooked ; the tough central core 
of the carrot and the fibrous structure of tbe parsnip render 
them difficult of digestion. They all excite flatulence, and 
are not suited to a delicate stomach. 

(7) Nearly the same remarks are applicable to cabbage. 
There are many individual peculiarities regarding the cab- 
bage group, however, and we have noticed that for some the 
raw cabbage excited less eructation t ban the cooked. Some 
persons eat cabbage with impunity, others with much dis- 
tress. Hence, in giving it to a child, each time the results 
should be noted, such as whether ornol flatulence, belch- 
big, rising in the throat, etc., occur. 



SLEEP. 



Hours of the Baby's Naps. 

How many hours long should a well, hearty baby of three months 
sleep at night, and at what hour should it retire? Should it take one 
or two naps during the day, and at what hours should these be? 
Newport, R. I. J - S - R 

Put to bed not later than 7 P. M. ; earlier if your do- 
mestic arrangements will admit. As a general rule it is 
better that Baby be put to sleep before the mother's evening 
meal, otherwise the latter has to hurry her own eating or 
keep the baby unsettled too late. A healthy baby of three 
months sleeps, with interruptions for nursing, practically 
all the time from tea-time to breakfast-time, the breaks 
being, the first, say, at parents' bed-time, which we may 
assume to average about 10.30 or 11 o'clock ; a second at 3 or 
4 in the morning, and a third which generally precedes the 
mother's rising hour. Variations of all sorts, of course, 
occur from this standard, as many babies elect the evening 
for a "worrying time," aud the mother has to conform to 
circumstances ; but the schedule given is about what should 
be aimed at. If the child will sleep longer than four hours 
at a time it is well to allow it to do so by all means, unless 
the mother's breasts become overfull. The baby should 
have at least two day-naps, and if only two are taken the 
most convenient times for dividing the day will be at about 
10 a. m. and 2 to 3 p. m. 



8 LEE P. 73 



Position for Sleep. 

Dr. Donaldson, in his "Decalogue for the Nursery," says a baby 
ought always to lie prone, or on its stomach. How can it breathe then 
— or must its little neck be twisted so that it will lie on the side of its 
head while the rest of the body is flat? 
Pennsylvania. A Seekek After Truth. 

In our judgment what is called by physicians the 
"semi-prone" posture is most natural to babies, as to the 
inferior animals, i. <?., on the side, but with the back turned 
a little up. In this position a slight turn of the head makes 
breathing easy, and the weight of the abdominal organs 
rather helps than hinders respiration. 



Crying to goto Sleep— Pain of Teeth-Cutting. 

What I'd like to know is the philosophy of a baby crying to go to 
sleep, and of the pain of teeth-cutting — both natural functions, and in 
the case of sleep (except in babyhood) nature induces its own result 
and requires no assistance. 

Xew York. H. S. S. 

Like many others, you seem to think that a process that 
is physiological is necessarily free from discomfort. Would 
that it were so! For a physiological process to go on pain- 
lessly and unconsciously proper surroundings are necessary. 
A tooth may and often does press its way through the gum 
without evident distress ; but even in many of these cases 
the observant attendant recognizes certain motions of the 
mouth which show that the child is conscious of something, 
even if it does not cry. The irritation may also make the 
child more excitable, cither to pleasure or to grief, than usual. 
But this is in no way peculiar to teething. The whole 
process of digestion may be attended with discomfort. One 
child will eat a banana without apparently any effect; the 
ncxl child has convulsions from eating one. The difference 



74 N URSER 7 RR OB L EM*. 

is not in the process, but in the individual power of digestion 
and susceptibility of the nervous system.. So later in child- 
hood or adolescence come many derangements — e. g., "grow- 
ing pains," the developmental discomforts of both sexes. 
These are all natural processes ; but in order that they may 
be painless the system must be in an entirely proper physi- 
ological condition. 

Take sleep again. It is not true that "nature induces 
iis own result and requires no assistance," except under 
favorable circumstances. With the man who has health a 
perfect digestion, enough to do to produce gentle fatigue and 
not too much, who has no worries and who goes to bed ex- 
pecting to sleep till the breakfast-bell rings, nature "requires 
no assistance.'' Let any oneof these requirements be want- 
ing and see what nature will do. The practical point here 
is this: Babies "worry" at going to sleep usually from 
fatigue. They are kept awake until their little strength 
is exhausted, and their fretting causes the first recog- 
nition their fatigue receives. It takes time for the nervous 
system to quiet down. The same is true of older children. 
The judicious attendant l>. gins to quiet the baby or the older 
child in advance of fatigue. The baby may be usually lulled 
to sleep when the time for slumber is approaching ; the 
older child's play may be interrupted by a quiet story-telling 
or singing, and sleep comes, if not i romptly, without weep- 
ing. 



Short Intervals of Sleep. 

What can I do to induce longer intervals of sleep? My baby is 
six months and a half old and is partly bottle-fed, being nursed only 
two or three times during the day, but having the breast all night, 
after one bottleful upon being taken into bed at first waking. I usually 
manage to get him to sleep before eight o'clock, and sometimes he does 



SLEEP. 75 



not wake till ten. After that time he wakes at regular intervals of 
two hours — seldom longer — all through the night, and demands his 
"little (?) drink." I have vainly tried to send him off to sleep with- 
out it. AVith it he is soon asleep again. 

This constant nursing is a great drain, and leaves me very jaded 
and weary when the night is over. In the day time he goes three 
hours usually, though the time is sometimes longer and sometimes 
shorter. 

Collingwood, Ont. C. A. X. 

The trouble is probably partly due to the short iutervals 
of feeding by day as well as night. He gets breast or bottle 
on an average about every three hours ; at his age a healthy 
baby ought to be able to go four hours without distress. 
The frequency of feeding is, within limits, much a matter of 
habit with every one, adult or infant. We would suggest 
increasing tbe amount of food at each feeding, to be followed 
by a longer interval. In this lengthened interval a larger 
supply of breast-milk will have accumulated, which will 
enable him to go longer to the next feeding or nursing, and 
soon. Thus the habit of a longer interval could be estab- 
lished, which would be for the night as well as the day. We 
think you would save yourself by feeding at least once in the 
night. 



Wakefulness. 



I wish to get some advice as to the hest way to make my bahy 
sleep evenings. He is nine months old, is apparently perfectly well, is 
fed regularly five times a day with food which seems to agree with 
him ; sleeps from about nine to eleven o'clock in the forenoon, and 
from half past one to three in tin: afternoon ; usually sleeps all night 
from half past ten or eleven until six or seven in the morning, and is 
never fed in the night. From the time he was six weeks old he has 
been put to bed at seven or half-past every night, but has seldom slept 
through the evening. He generally Bleeps for twenty minutes or half 
OH hour, and then wakes and cries until 1 go and sit by him. Some- 



76 NURSERY PROBLEMS. 



times after worrying for nearly an hour, I and I only, can coax him 
off to sleep, but frequently he stays awake until we all retire. I tried 
letting him cry every night for over three weeks by the physician's 
advice, but to no effect, and have also tried warm baths at night with 
no better success. Nervousness seems to be the cause of his wakeful- 
ness, although he is never troubled that way during the day. Can 
you suggest some remedy which will prove effectual '.' 

E. W. P. 

The problem you present is not a rare one, but it is a 
difficult one. Your child's habits of eatiug seem to be all 
right. He sleeps about four hours by day and eight to eight 
and a half hours at night, besides the nap early iu the eve- 
ning, in all from twelve to thirteen hours per diem. This is 
of course much less than most children of the age of your 
child take, and less we think than most such need. 

The cause of the wakefulness in this case is not evident, 
but we may offer several hints which may lead you to the 
cause. First, is the child hungry at the time he goes to bed? 
We presume that he has a meal j ust before he goes to sleep, but 
this may not be so, aud the interval may be too long before 
he falls asleep. Second, is he too tired when night comes to 
go to sleep? Third, is his sleeping place too near the sit- 
ting room so that the evening bustle, generally attending 
the home-coming of the father, excites or disturbs him; 
or fourthly, is he, on the contrary, in a room so dark that he 
is timid, as many children are in the dark ? And lastly — 
and this cause we think quite commonly overlooked — does 
the father smoke in the baby's sleeping room, or a connect- 
ing room? Sensitive children, aud adults for that matter, 
are often much affected by air rendered impure in this way. 
If none of these suggestions help you, you may find, us is 
sometimes the case, that keeping the child awake a little 
later than you hitherto have done in the early evening, may 
insure a sound sleep when he is put down. 



The Causes of Restlessness at Night. 

My little 1) y . ■ . ■ _ .rs. is very well apparently 

in every way, bui he has a habit of tossing about in his sleep almost 

allnigi: . . -- I suppose I har r 

twenty :.. . . and if 

- can I remedy it? Is the following dietary a judicious one 
for a child of my boy 'e s 

Breakfast at 8 j^. M. of oattbdtes and milk, or wheatena ar.d Tnilfc 

l K. beef-juice from J£ lb. of meat, and a crust of bread. 
Dinner at 1 P. 1L of mutton broth and bread ; chop and baked potato. 
:. or chicken : baked apple or a peach cut up with sugar. 
I 5 p. 3i.. milk-toast, or bread and butter and milk. 

This diet seems to agree perfectly, but I cannot see what makes 
Be goes 1 t7p.M. and sleeps until 7 j.. 

M., being taken up twice during that time to make water. He is out- 
of-doors abaaost all day. and never has any candy, or anything 
his meals. 

JYetc York L. R. 

The dieta: -eerus to be entirely proper, and it 

•. rotable that the restk ie to any article of 

food. The ea - are many, and in 

ijldren they are nev c r discovered, and disappear with 
the lapse of time. But, as is well known, it often exists 
through life. In such cases much must be set down to indi- 
vidual peculiarity. Among the recognizable causes are im- 
mediate indigestion, due to some improper article of food : 
remoter indig such ; arises from the inability < 

persons t-> \ i rdinarfly proper — for in- 

- - _ r ar. etc. : flatulence, distended blad- 
ind in fart any alight affection which may 
give a trirl:: g discomfort which, while not enough t-> dis- 
turb the litst heavy sleep of the night, makes itself felt after 
the body is partly rested. We ought to mention the pecu- 
rickety children, who resent warm 
it, and usually have perspiring he 



78 NURSERY PROBLEMS. 



night. Many of these causes you seem to have thought of; 
the others suggested may put you upon the track of that 
which is active in your child's case. 



The Fir-Pillow. 

Will you please inform me whether the fir-balsam pillow is really 
quieting and beneficial to a restless, nervous child? If so, where can 
it be obtained? 

Canfield, 0. F. M. S. M. 

The fir-pillow is an "aesthetic" fancy much used as a 
lounge ornament in towns. The odor is very grateful. The 
emanations of evergreen trees have been sometimes thought 
to be beneficial to those suffering from pulmonary com- 
plaints, but their value, as distinguished from that of the 
surrounding health-giving circumstances, is not proven. It 
is possible that a nervous child might be pleased with the 
odor of the pillow, and so quieted, but we do not suppose 
that it has any real medicinal value. The ancient pillow of 
hops is quite as efficient. The materials for filling pillows 
are prepared throughout the fir-bearing regions wherever 
summer visitors go. The cost is slight. 



The Hammock as a Sleep-Inducer. 

Do you consider hammocks injurious to babies? My baby is 
nearly five months old, and for four months I have used a hammock 
for her, getting her asleep in it. It made her sick once, when 1 first 
got it. "With this exception I have never been able to discover any 
bad effects from it ; but I have often wondered if it could be harmful 
in any way. 

Toledo, 0. J. B. M. 



SLEEP. 79 

The hammock, if not violently swung, is no more in- 
jurious than the cradle or the rocking-chair, presupposing 
that it is a full-sized hammock, which allows the child to lie 
without being doubled up. The whole question whether 
any kind of oscillation is worth while as a means of getting 
a child to sleep we cannot enter upon. Such manoeuvres 
are not necessary aud, if begun, usually must be continued. 
The child is not benefited, the mother is taxed. Neverthe- 
less the pleasure of putting one's baby to sleep in the arms 
often, if not always, repays the mother for the taxation, at 
least while it is not too heavy. And in view of the genera- 
tions of our cradle-rocked and chair-tilted ancestors we can- 
not say that these rhythmical motions are usually injurious. 



Putting a Baby to Sleep With the Rubber 
Nipple.— "Magic" Effects of "Sugar- 
Rags." 

How shall I teach my four-weeks-old girl to go to sleep alone by 
herself? A friend of mine accustomed her first baby to go to sleep 
with a rubber nipple in her mouth, which practice she kept up till she 
was three years old. Does this ever produce sore mouth ? 

Although "sugar-rags" are an abomination to me, I have been 
guilty of trying them after all other means have failed, and when im- 
perative duties demand my attention. The effect has been magical, as, 
in almost the time it takes to tell it, she would be sound asleep. When 
awake she is as good and quiet as I can wish for. 

Titusville. Pa. A Vouni; Mother. 

A four-weeks-old baby ought to sleep two-thirds of the 
time, if she is well. Nurse her to sleep, and when her lips 
slip from the nipple lay her down carefully in the crib. 
Unless your nurse has already accustomed her to rocking 
and "coddling" on the lap, you should have no trouble in 
getting her to Lie still by the hour, sleeping or waking. Why 



.A' I Us EI! Y PR OB L EMS. 



give her the rubber sham at all, since she will only suck in 
wind aud form au absurd habit ? 

As to the sugar-rag, the saccharine, farinaceous, and 
greasy foods that make up its contents seriously derange a 
baby's stomach. Colic, wind, and disordered bowels follow 
in the train of the objectionable pellets. 



Experimenting with Anodynes. 

"Will you please tell ine what anodyne is best for inetogivemy 
six-months-old baby ? She is a bad sleeper and I cannot stand being 
awake so much at night. I have given her chamomilla, and once or 
twice a drop of laudanum. Is there anything better than these? 
Utica, N. Y. K. L. B. 

We advise you to give no anodyne at all nor any sleep- 
produciug medicine, unless it is recommended by a physi- 
cian after a thoughtful consideration of her case. The 
proper thing to do is to seek to the best of your ability, 
aided by your physician if necessary, for the cause of the wake- 
fulness and remove that cause if possible. A cause exists 
and can usually lie found. 



A Night-Light in the Nursery. 

"What is your advice about burning a dim light in the nursery at 
night ? Can it have a bad effect on children's eyes ? 

Henderson, X. C. T. M. P. 

The light will do no harm, especially if it be so shaded 
as not to fall directly upon the child's face. 



Sleeping with Arms Up. 

Will you please tell me whether it is injurious for a child to sleep 
with its arms above its head? Our sixteeu-months girl habitually 
sleeps in that position, and I have vainly tried to cure her ; the least 



SLEEP. 



attempt to move and keep her arms down makes her toss and throw 
them up, and if persisted in she wakens ; and as I live in the country 
and do my own work, I do not like to do anything that will keep me 
awake at night, unless it is necessary for Baby's comfort. 

Lee Co., Iowa. R. N. McC. 

We have often heard objection made, particularly by 
"old-fashioned" nurses, to patients' sleeping with their 
arms up. But no reason for the objection has ever been 
made clear to us. We suspect it is this : If a sleeping per- 
son keeps his arms or any part of his body in a position 
which requires a muscular effort to maintain it, it is evident 
that tbe relaxation of perfect sleep has not occurred. The 
posture is probably not the cause of the imperfect sleep, but 
the result. But there are persons who sleep with their arms 
raised with perfect comfort and apparent refreshment. If, 
therefore, you cannot find any evidence of ill-health or any 
other cause for your child's habit, it seems to us better that 
you should let her take her sleep as she best enjoys it, taking 
care that her arms and chest are warmly enough clad to pre- 
vent chilling. 



Sleeping in One Position. 

(1) Is it harmful for a baby nearly three months old to lie on his 
rightside nearly allthetime? Heliacal ways seemed more comfortable 
lying in that way, and is often very restless if put on his left side. He 
now sleeps from G r. M. until nearly 5 A. M. I put him in his crib 
wide awake after nursing him, and leave him with a little light shin- 
ing in the room and he goes to sleep alone. Would it be better to turu 
him over if he seems quiet and comfortable? 

(2) Is it common for so young a baby to sleep so long without 
nourishment? Both of my babies have done so, but it seems a long 
time to lie in "in' position. 

Stoneham, Mass, M. A. 



NURSERY PROBLEMS 



(1) Ordinarily it is better that a child should change his 
position . There are exceptions to most rules and there may be 
to this, and if the child seemed really uncomfortable upon the 
other side we should not distress him merely for the sake of 
a rule. Nevertheless, if he sleeps very long in one position 
we should prefer to turn him over while yet asleep, to ob- 
serve whether while asleep he were apparently any less 
comfortable in one position than another. 

(2) It is not common, but sometimes we have seen it. 
Perhaps it would occur oftener if attendants were more 
judicious. 



Jumping in Sleep. 

Can yon explain to me why my seven-months-old little girl jumps 
in her sleep every few minutes, as though very much frightened, wak- 
ing herself up crying? By rocking and quieting her she will fall a- 
sleep again for a few minutes, only to j ump again. The slightest noise 
will wake her up when sound asleep at any time. 

I would add that we are raising the little one on the bottle from 
necessity, and for a good while we thought her jumping was caused 
by our putting her to sleep on a full stomach just after eating; we 
watched her closely to ascertain if this was so, but could not come to 
any satisfactory conclusion. If you can give me any light as to this 
difficulty it would be greatly appreciated, as we have had a great deal 
of trouble in this direction with our little one. 

Utah. C. 

To answer the question definitely is impossible, but the 
following hints may help you to find out the cause. You do 
not state whether the broken sleep has always been a charac- 
teristic of the child, but we presume that it is a rather new 
symptom. Most children in health sleep quietly ; a dis- 
turbance of sleep is presumptive evidence of some de- 
rangement of health. The causes of this disturbance are 
manifold : Any rise of temperature of the body ; too 



SLEEP. 83 

much or too little covering ; too high or too low a tem- 
perature iu the apartments ; slight local irritations, such 
as tender gums from a coming tooth ; the presence in the di- 
gestive tract of undigested, indigestible, or irritating food, or 
even food that is laboriously digested ; flatulence or seat- 
worms — not to mention more serious ailments. Your little 
child seems to be naturally a light sleeper, and if we were 
to hazard a guess it would be that the source of irritation is 
in connection with the digestive process. 



The Pillow. 



I would like very much to know your opinion in regard to pillows 
for little folks. Are they better off without any ? 

Manson, Iowa. A Mother. 

A very little baby does not need a formal pillow, as its 
mattress is often somewhat raised attheend, and the flexible 
little body accommodates itself to almost any manner of 
lying. But there can be little doubt that by the time a child 
is big enough really to lie upon its side it will be more com- 
fortable if its head be slightly elevated. With a high pillow 
the neck is twisted upward ; with no pillow it is twisted 
downward. 



TEETHING. 



Late Teething. 

A thing that has puzzled me is your evident disapproval of late 
teething. I cannot think that my baby had any tendency to rickets, 
as he was exceptionally strong and robust, but when a year old he 
had only two teeth, and did not get the stomach and eye teeth until 
two years and a half old. He seems to have good teeth, and I had 
somewhere imbibed the idea that late teething made good teeth, as I 
knew of four children who got no teeth until about a year old, all of 
whom had beautiful teeth in after-years. Will you not sometime give 
a little more fully your reasons for condemning late teething as un- 
healthful ? 

Buffalo, X. Y. L. P. M. 

We neither approve nor disapprove of late teething. 
Some normal differences exist as to the time of teething — the 
medical books set seven months as an average for the first 
tooth to show, but many children begin two or three months 
earlier, and some later. The reason we have so frequently 
mentioned late teething is that, by common agreement of 
all who have studied the subject, it is one of the signs of 
rickets, and it is a sign easily noticed by the mother, while 
she might overlook others. We have insisted a good deal on 
rickets, because, in its less marked forms, it is one of the 
commonest disorders of early childhood, and one which 
seems to be habitually overlooked unless it has advanced to 
the degree of producing deformities. 



TEETHING. 



Late teething is never an advantage. A child's teeth may 
be delayed by rickets, and, after his recovery, come through 
in good enough shape, and the second set of teeth may es- 
cape damage altogether. The late examples you speak of 
were probably, to judge from the usual course of such cases, 
children who were kept on breast-milk which was really not 
up to the mark, and only after weaning did they get 
material to push their teeth with, or, if bottle-babies, they 
had at length become accustomed to their food. 

On the other hand, late teething alone, i. e., unaccom- 
panied by any other evident derangement of health, cannot 
be accounted a disease. 



Arrested Eruption of Teeth. 

Baby is ten months of age. I was obliged to wean her at three 
months, and found do other food to agree with her except condensed 
milk. She has been taking this five times in twenty-four hours — 
from 6 A. M. to 6 p. M. — every three hours regularly, nothing else, and 
in regular quantities of l>o tablespoonfuls of the milk to 15 of boiled 
water; water once in a while. She makes no demands for food dur- 
ing the twelve hours of night ; is well, regular, and happy. She had 
eight teeth when she was eight months old, but there are no signs 
now during these two last months of others coming. Is it not time 
to give her other and more nourishing and less sweet food, as she is 
very active and almost walking, and, if so, what do you advise ? 
Dorchester, Muss. M. A. K. 

There is nothing strange in the arrested eruption of the 
teeth. They came very fast, and there usually is a rest be- 
fore the molars Come and another rest before the canines 
appear. On general principles we dislike sweet food, but we 

arc bound lo say that in your child's case we see no evidence 

of its disagreeing or of the nutrition being defective. 



N URSER Y PROBL EMS. 



Drooling. 

Can anything be done to stop a child's "drooling" ? My boy, now 
nearly two years old, has drooled constantly since he was two months 
old. He had no teeth until he was seven months old and now has 
sixteen. He got the bottle until a year old. He is not unnaturally 
thirsty, but likes something wet in his mouth and never loses an 
opportunity to take a wet cloth or sponge. I have spoken to two good 
physicians, but they seem to regard it lightly and tell me I may be 
thankful nothing of importance is the matter with him. Let me say 
that the child is as forward in everything as others of his age. Have 
other mothers this trouble ? I cannot hear of a similar case. 

St. Paul, Minn. N. J. 

We may say first, to relieve your anxiety, that the ail- 
ment in all probability "is nothing more serious than an 
annoyance. " Quite evidently something has overstimulated 
the salivary glands and the child's desire to take wet things 
into his mouth suggests that he is conscious of an irritation 
of the glims. Very possibly the remaining teeth of the tem- 
porary set are in process of eruption ; and when this is over 
the irritation will probably cea^e. Another possible cause is 
this : If there is any obstruction to free breathing through 
the nostrils, the opening of the mouth may stimulate the 
flow of saliva. At all events such cases of constant drooling 
are not rare. 



Drooling Not Teething. 

Is the time when a child begins to drool the time when "the teeth 
start in the gums"? When does the drooling usually begin ? My 
boy is six months old, sleeps without waking at night, is fed four times 
in the day and is well and good-natured. The artificial food I use I 
have not seen mentioned in Babyhood, and it is excellent in every 
nourishing way, easily prepared, and cheap. It is bran gruel— two 
cups of bran to a quart of boiling water ; boil nearly an hour ; strain ; 
strain again through a cloth. I am now using one-third each of gruel, 
water and milk. 

Georgetown, Col. A. E. P. 



TEETHING. 87 



The drooling is not due to the teeth, but to certain 
changes in the condition of the salivary gland. It begins, 
on an average, we should say, at about four months, but 
varies much in degree as well as in time. It happens fre- 
quently that it coincides with or precedes the evolution of 
the teeth, hence has popularly been supposed to be due to 
the latter. Mothers often express surprise that teeth do not 
appear because the baby "has been teething since" such or 
such a time, their opinion being based upon the salivation or 
some other disturbance which had no particular relation to 
the teeth. 



Is Normal Teething Painless? 

Apropos of Dr. Dorning's article on "Common Disorders of 
Teething-time Unrelated to Teething," I would like to ask if we 
mothers are to infer that the teething of healthy children is without 
pain or discomfort? I am no believer in the theory that every de- 
rangement of the system during dentition is attributable to that as a 
cause; neither am I of the number whom the writer so sarcastically 
characterizes as "those who have an unshaken faith in the occult in- 
fluence of phylacteries and the different forms of witchcraft on the 
teething baby." But after an experience with three strong, healthy 
babies of my own, I cannot readily accept the theory that — as one 
physician expressed it — "dentition is as painless a process as the 
growing of the ringer-nails." 

My little six-year-old, just cutting the "seven-year molars," com- 
plains frequently of soreness and discomfort of the gums. Is it irra- 
tional to believe that a younger child, with less vigor for endurance, 
suffers equal discomfort in cutting the first teeth, and that, using the 
only means of expression at his command, he becomes fretful and 
peevish, gradually developing more or less feverishness inconsequence 
of the discomfort? 

My youngest child, whose dentition has been very slow, cut her 
third incisor when she was fourteen months old. For weeks the tooth 
had seemed so near the surface that I expected every day to feel its 
edge. Hi' n the gum became inflamed, the covering skin was hard 



NURSERY PROBLEMS. 



and tightly drawn, the child fretful. On the fourth or fifth day I dis- 
covered a small gathering of pus at one corner of the uncut tooth. I 
sent for my physician, who lanced the gum, freeing the tooth and 
giving immediate relief to the child. Is such an experience unusual, 
and what is the probable cause of the pus? The child has no tendency 
to humor of any kind, and at the time was in her usual health. 
Could such a case be attributed to derangement of stomach or bowels, 
or was I right in considering it an incident of dentition ? 

I ask for information, and because I believe there are other 
mothers who would like an answer to the question, who are perfectly 
willing to discard the "traditions of the elders" as to the many dan- 
gers of teething time, but who are not ready to lay aside all sympathy 
for a teething baby. 

Any one who remembers the soreness of gums and the positive 
pain often attendant upon the coming of wisdom teeth, has strong 
ground, it seems to me, for pitying a little child whose first teeth are 
pricking their tedious way through the gums. 

Plymouth, Mass. K. M. S. 

Let tin put it in another way. Not "that the teething of 
healthy children is without pain and discomfort," but that 
pain and discomfort — if unusually great— are at least pre- 
sumptive evidence that the process of the evolution of teeth is 
not going on in a normal or healthy way. This change is not 
a quibble, but a different point of view. For, first, the 
phrase, "a perfectly healthy child," has no meaning unless 
that judgment has been passed by a competent authority. 
We recall scores of children so described to us which were, 
to our mind, anything but healthy. Further, in practice we 
have, not so very rarely either, been asked to admire as evi- 
dence of unusual health or strength what we considered 
marks of disease. What is generally meant by the phrase 
"perfectly healthy" is that the person described does not 
come, or at least comes rarely, under medical care. In adult 
life persons who attend without complaint to their daily 
avocation are considered " perfectly healthy," although one 
may have chronic constipation, another frequent headaches, 



TEETHING. 



or oft-repeated neuralgic affections, while another may have 
all the obscurer manifestations of gout, but escape the typi- 
cal swollen toe, and so on to the end of the chapter. 

Now, the change of view regarding teething which has 
come to the great majority of physicians who especially 
study children's diseases is not that they do not think that 
the baby suffers or that they do not sympathize with its suf- 
ferings, but that they no longer think that this suffering is 
natural or normal. If the child suffers much from denti- 
tion, even locally, they think that the child was not entirely 
well, or the reaction of a physiological process would not be 
so severe. Very often indeed one skilled in children's ail- 
ments can point out where the deviation from health is 
which probably underlies the troublesome dentition. We 
do not say that it "is as painless a process as the growing of 
the finger-nails," but many experts at least will be inclined 
to say that in health it ought to be. There is no manner of 
doubt that children's gums are often painful at dentition — 
we do not here discuss the remoter ailments often charged 
to dentition — but it is doubtful if the pain ought to be 
of such a nature as to disturb sleep or to cause any 
great discomfort. Take a case from your own letter. 
Your little one cuts its third incisor at the age of fourteen 
months, a delay so great as to be of itself sufficient cause for 
looking the cbild over carefully for a disordered condition of 
nutrition to account for it. Then an abscess forms in the 
gum. This shows very unusual irritation, and according to 
our present belief pus cannot form unless the necessary 
micro-organism has been introduced, in this case probably 
from without. The^occurrence was "an incident" (or rather 
accident) "of dentition." it was probably not due to any 
temporary derangement of stomach and bowels, but rather 
primarily to that peculiarity of system which delayed den- 
tition, and, as we said before, to the introduction of one or 



90 NURSERY PROBLEMS. 

other of the pus-exciting organisms into the tissue, most 
likely from without through handling the gum or the chew- 
ing upon some substance, as teething children often do. 

The change in view, we have said, leads not to any doubt 
of the baby's suffering, but to giving greater attention to his 
condition— to the condition before and during teething with 
the view of preventing pain and illness. We may quote 
ourselves here. 

"The question is at once asked : What does it matter to 
us in the nursery whether the many disorders attending 
teething are caused by it or not ? Just this : If the parents 
believe that dentition causes all the ailments attributed to it, 
they are, as we daily see, prone to consider the ailments as 
nearly, if not quite, as much a matter of course as the 
natural teething process, and they consider it useless to try 
to cure them until teething is complete. Moreover, by a 
sort of inverse reasoning, if any of the disorders which they 
are accustomed to regard as dependent upon dentition hap- 
pen to exist, they infer that the child is teething, whether 
he be so or not. As a result of all these errors and con- 
fusions, it too frequently happens that disorders which 
might have been very tractable at the outset are allowed to 
progress unopposed until they reach a serious stage. If, on 
the contrary, we assume that teething is rarely the real 
cause of disease, the parent will seek some other reason for 
any disturbance of the system that may exist, and will en- 
deavor to remove it, either with or without the aid of a 
physician. The difference of opinion is then not a simple 
dispute of terms, but one which has a real interest in the 
nursery." 



HYGIENE AND SANITATION. 



Disinfectants. 

Will you tell us of an article or articles to use as antiseptics and 
deodorants for a cesspool whose funnel-shaped opening is near the 
house ? Dish-water and such slops only are emptied into it, and it 
discharges into a rapidly flowing creek about thirty feet distant. 
Minneapolis, Minn. A. 

One of the cheapest articles is sulphate of iron (copperas), 
which may be thrown into the cesspool if it contains stand- 
ing liquid ; if not, dissolve the copperas in a pail of water. 
Common rock-salt used abundantly is useful, and more 
powerful than either is a mixture of salt and sulphate of 
zinc — say three parts of the former to four of the latter — dis- 
solved in water and poured into the cesspool. 



Ground Air from Excavations. 

A serious defect in our drain renders it necessary for us to lay 
new pipes outside the house. This of course means the turning up of 
impure earth. Will you suggest some safeguard for children who, 
while playing outside, are somewhat near the trench ? The work may 
take a week or more. Would you advise quinine to be given during 
that time? 
New York. ' W. S. T. 

Chlorinated lime in powder or a copperas solution, 
sprinkled over the earth, are probably as good as anything. 
If in a district where fever and ague often appears, the 
quinine may be given in moderate doses. 



NURSERY PROBLEMS. 



Temperature of the Nursery and the Bedroom. 

What is the proper temperature of the night and day nurseries ? 
Charlottetovm, P. F. I. A Puzzled Mother. 

Day nursery 65° to 68°, or, at most, 70° F. Some strong 
children can get on at a lower temperature than 60°, but the 
figures set are the best average. The night temperature may 
be cooler, but not so very much, as the child is liable to toss 
its bedclothes off. 



Gas Stove in the Nursery. 

My nursery is over the kitchen, but cannot be heated from it. 
There is no room above. "We rent the house. I put in last autumn a 
small stove to be open or shut, and burn either wood or coal, but it 
sent out so much gas and smoke that, it being a warm season, we 
seldom used it. The afternoons are not cold enough to require a fire 
in the room, but I must have some way of heating it before the baby 
comes from her bedroom in the morning. The chief difficulty with 
the present stove is that the hole into the chimney is rather low, and 
the draught is not good, especially when the kitchen stove is first lit. 

Could I use a gas stove, or anything else that would not require 
connection with that bad chimney? Please tell me what would be the 
best, and, incidentally, the least expensive method of heating this 
room. 

Washington, It. C W. J. M. 

A gas stove of the ordinary kind is always very objection- 
able, because the products of combustion are left in the room, 
and the air is more vitiated by one, even if small, than it 
would be by the presence of mauy persons. If you can find 
any form of good gas heater with an escape flue for fumes it 
might do. The chimney certaiuly ought to have a separate 
flue for each room. Your nursery stove, in a properly con- 
structed chimney, ought to draw all the better if the kitchen 
fire has already warmed the chimnev. If vou cannot find a 



HYGIENE AND SANITATION. 



stove that will draw properly, we think the best plan would 
be to carry the pipe of the kitchen stove through the ceiling 
and into the chimney in the nursery. In your mild climate 
sufficient heat would probably be given off from the heated 
stovepipe for the needs of the nursery. 



The Desirability of Keeping Water on the Stove. 

I would like to ask your opinion as to the desirability of keeping 
a vessel of water on the nursery stove. Formerly I thought it was the 
proper thing to do, to keep the air moist. Then I was told that the 
steam was considered objectionable, inducing throat troubles. Which 
theory is correct ? 
Lancaster Co., Pa. A Mother. 

It is hard to prove anything as regards the effect of a 
vessel of water or its absence, but our own notion, which we 
offer for what it is worth, is this : A vessel on a stove hot 
enough to generate steam is not desirable except as a remedy 
under certain circumstances, as, for instance, in croup. But 
if a room is heated in such a way as to make its air too dry, 
a broad vessel of water standing in the room may give off 
enough vapor to mitigate this dryness. The vessel may be 
near the stove, but should not be so placed as to generate a 
visible steam. 



Plants in the Bed-Room. 

I wish to ask your advice about having plants in a bed-room. I 
am so situated that my bed-room must also be my nursery, and I 
should like to make it as attractive as possible. A bow-window 
all'onls plenty of sunshine from seven o'clock a. m. until five o'clock 
P. m. Is it unhealthy to have plants growing in a bed-room? 
Bockwood, Term. B. A. B. 



XUItsEflY PROBLEMS. 



Plants are not usually injurious in a room during the 
daytime. When there is sunlight the plants absorb carbonic 
acid and appropriate its carbon and set free a certain amount 
of oxygen. This process is not harmful, but rather the reverse, 
to animal life. The only harm that need be considered is 
that possibly arising from any considerable quantity of damp 
earth in the room, but this is probably very slight. But with 
the coming of darkness this process of absorption of carbonic 
acid ceases, and a certain amount of the gas is given off; just 
how much, of course, varies with the quantity and kind of 
plants in your greenery. The effect is in kind, if not in 
degree, very much the same as that of having another per- 
son sleeping in the room. If you can arrange your plants 
upon a stand with castors that can be rolled out of the room 
before sundown and brought back in the morning, the plants 
will probably be harmless ; otherwise they are better away. 



Proper and Improper Filters. 

Will you please tell me what kind of a filter is best to use for 
filtering water ? I have read so much both for and against filters that 
I had come to the conclusion that there was about as much danger in 
using the ordinary filter as in giving the water unfiltered, but after 
reading an article on "Intestinal Worms" I would like to have your 
opinion on the subject. 
Elizabeth, N. J. P. T. N. 

If you care to buy one of the well-known "Pasteur" 
filters which are rather costly, and will keep it in order, you 
will have, we think, a safe article. Ordinary filters, we be- 
lieve, do more harm than good. They strain out coarse dirt, 
but they are admirable culture places for all the micro- 
organisms found in water. Our favorite device for cleansing 
water is to have a number of bags made of stout flannel 
with strings at their mouths. Oue of these is tied over the 



HYGIENE AND SANITATION. 



opening of the faucet and the water turned on gently ; this 
strains out coarse (visible) dirt. ISTo bag should be used 
more than one day, and if the water is unusually dirty, the 
bags may be changed several times daily. They should be 
thoroughly boiled before being used again. If there is any 
reason to suppose that the water is unwholesome, it should 
be boiled before using. It may be kept in stoppered bottles 
or jugs, and if desired for drinking, a bottle may be easily 
cooled in the refrigerator. 



The Relations of Kerosene to Diphtheria. 

Is there any truth in the statement of a New York physician that 
diphtheria is more prevalent in homes where kerosene is used for light 
or fuel ? This opinion has been both denied and corroborated, and 
I wish to know if it has, in your judgment, any foundation. 

Bingham, 31ass. M. L. 

We have never before heard the statement, and we 
know of no facts that would support such a belief. If 
kerosene were burnt in a room either for light or fuel, and 
the results of combustion not properly carried off— as hap- 
pens usually when lamps or stoves without chimneys are 
usctl — of course the air would be by so much impure, and 
foul air from whatever cause impairs the general health, and 
renders the system more susceptible to nearly all forms of 
contagion. Beyond this nothing can be proved. In great 
cities gas is the ordinary source of light, and lamps are 
chiefly used in those dwellings which have a crowded 
population, and it would be very easy to say that such or 
such a district bad a greater prevalence of diphtheria, and 
thai also it was a district in which kerosene was much used, 
but there would be no evidence so far of any connection be- 
tween tbe two (acts. This method of reasoning is one of the 



96 NURSERY PROBLEMS. 

most pestilent sources of error in medicine. If any depend- 
ence of the disease upon the use of kerosene is to be shown it 
must be by strict observation and analysis of the results ob- 
tained. 



Paper-Money from a Sick-Room. 

My next-door neighbor borrowed twenty dollars of me a week 
ago. To-day he returned a twenty-dollar bill in a note of thanks by 
his boy. My wife saw the boy from an upper window, coming in 
the gate, and knew I was about to open the door to let him in. She 
also knew that since the money was loaned two very severe cases of 
measles had developed next door, the said boy having himself just 
previously recovered. She knew, further, that as no attempt had been 
made to quarantine either of the three children, this young hopeful had 
as likely as not just come from the sick-room. Another thing she knew 
was that there are two babies in our own house. 

It is not strange, therefore, that at this point in my story my bet- 
ter three-quarters appeared on the scene ; and when my better three- 
quarters appears on any scene in which the babies are involved it gen- 
erally means business. This was the business : "Charles ! Charles ! 
whatever Willie Smith gives you, be sure to burn it up immedi- 
ately!" "All right," I answered, "of course I will!" adding 
mentally, "all except the twenty dollars." What to do with that I 
didn't exactly know ; but as I was on my way to the cellar to look at 
the furnace, I plunged the letter and envelope into the flames, putting 
on the draughts "one seven times hotter" than they were wont to be 
put on, and then pinned the bill up between the beams in a dark place 
by an opening into the yard, where a cold April wind was blowing 
through, and struck an attitude at a respectful distance with my eye 
on it while I paused to think. I couldn't quite make up my mind 
whether to let it stay there awhile and get aired out, or to pass it off as 
soon as possible on some unsuspecting denizen of the locality, or to 
take a complete record of its number, date, bank, and all particulars 
(it was a National Bank bill), burn it up, and then send the record to 
the Secretary of the Treasury, telling him the circumstances, and 
asking him if, in the interest of the public health, my praiseworthy 
act wouldn't entitle me to be indemnified by the government. 



HYGIENE AND SANITATION. 97 

It is now eleven p. m., and that bill hangs heavily on my mind 
and lightly on a timber of the dining-room floor, just about under 
where the oldest baby sat at the supper-table. I have concluded not 
to sleep until I have laid the facts before you, asking, (1) Could I re- 
cover anything from the Secretary of the Treasury, or would he ad- 
judge me daft? and (2) Is there any danger of contagion in such a 
case anyhow? By the time I can get an answer we will perhaps all 
have got safely through the measles, but the information will be good 
any other time. 

Bridgeport, Conn. D. Y. 

We have referred your first question (or the first part of 
it) to the Secretary of the Treasury, who replies that "the 
Treasurer can entertain no demand for redemption without 
presentation of the note, or, if mutilated, of so much of it as 
will enable him to identify it." 

As to whether there was any danger of contagion in this 
case, we think it hardly probable, but not at all impossible, 
and we commend the prudence dictated to you from up- 
stairs. If the bill is still hanging on the timber and none of 
your family have yet had the disease, you may with a clear 
conscience pass it upon any denizen. In another similar 
case you can disinfect the bill without damaging it, by either 
of two easy methods: Pour a little alcohol on apiece of 
sulphur and burn them on a brick or flat stone, laying the 
bill near them, and covering all with an inverted stone jar 
so as to secure the fumes ; or soak the bill in a two-per-cent. 
solution of carbolic acid and water. 



Susceptibility to Second Attacks of Disease. 

I have been told that a baby having a contagious disease while 
nursing will be liable to take it again. My little girl had the measles 
when ten months old. Do you think she would take them agaiu if ex- 
posed ? 
Dorchester, Mom. L. T. T. 



NURSERY PROBLEMS. 



There is no such rule. Children under six months are 
not very susceptible to measles or scarlet fever, and those 
under four months have very nearly an immunity from the 
latter disease. But a great many children have these dis- 
eases in the second half of the first year. It is true, also, 
that a good many persons have them, especially scarlatina, 
more than once. All any one would be justified in saying 
is this : If a child has measles under six months of age 
it is likely — other things being equal — that the child 
is unusually susceptible. Such a person is, of course, more 
liable to second iufection than another. In your child's 
case there is no ground for unusual anxiety. 



Physical Exercise for Girls. 

What physical exercises are best adapted for girls as distin- 
guished from boys? More particularly, ought girls from five to 
seven years of age to walk, run, and jump as much as boys of the 
same age? 

Omaha, Neb. M. T. 

Girls from five to seven years of age may practically 
have the same exercises as boys of the same age, with, per- 
haps, only a little reserve as to heavy exercise (in proportion 
to age), because even at this early age the boy usually shows 
something of the superior muscular strength that is so 
marked in adult life. But they may walk, run, and jump 
like boys if they are not unusually excitable girls. 



The Second Summer. 

(1) Why is a baby's second summer always the most dreaded? 
My little boy is just over a yearold and cannot boast of a single tooth. 
Will it be harder on him than if he had begun to get his teeth earlier? 
He is a big, fat, healthy boy, and very strong, quick to learn anything 



HYGIENE AND SANITATION. 



and to imitate. "What months are the best to take little ones out of the 
city, and do you know of a good place to go to for change from 
Brooklyn, not too far away ? 

(2) How ought a baby, expected in July, to be dressed — with just 
a linen shirt or linen and flannel both ? 
Brooklyn. M. R. B. 

(1) We do not know why the second summer is so much 
dreaded. It is not more fatal than the first ; on the con- 
trary, is much less so. The only explanation we ever heard 
of this peculiar dread was from a lady who said : " It is be- 
cause the baby lost in its second summer is much more 
missed than one lost in its first." We do not know that 
teething will be harder because it is late ; but if the child has 
reached a year without teeth he is probably not so strong as 
he looks. If you can be away so long, leave the city from 
the middle of June to the middle of September. If you 
must be in town some of that time, it is usually safer to stay 
in until July than to return too early. Probably the south 
side of Long Island is your most accessible place that is 
salubrious. 

(2) Liuen and flannel both, or at all events something 
woolen over the linen shirt. 



Baby Powder. 

What kind of starch or chalk do you consider innocuous used as 
baby powder? Carthage. 

Buy the best starch and pound it into powder, sifting it 
through coarse Swiss muslin or cheese-cloth. Perfume it 
wiili orris-root, and you have a harmless "baby-powder." 
Avoid the chalk us a toilet article. It has use in certain con- 
ditions of irritated skin, bul should not be used habitually. 



CONSTIPATION. 



A "Symposium" on Constipation. 
I. 

Don't you think suppositories of castile soap are preferable to bar- 
soap ? The old-fashioned molasses suppositories work more kindly 
with my children than anything else for constipation. 

F. 
II. 
In my experiences with two very constipated children I found 
that the use of soap and a roll of paper induced piles — quite as great 
an evil as constipation. 

My method, which entirely cured my babies of constipation, was 
to rub and knead the bowels with oil thoroughly every night and 
morning, and to put them on the stool at a regular time each day. 
With this treatment I adopted a laxative diet for myself, and when 
they were weaned gave them as laxative food as possible. 

I am persuaded that the use of soap, stick-candy, or paper, which 
produces an irritation of the rectum, is not always wise. 

Washington, D. C. C M. C. 

III. 

I would like to state my experience with a "constipated baby." 
From the time my baby was three weeks old till she became six 
months of age she never had a natural movement. Every day we 
were compelled to give her an enema. This was caused, we have 
always thought, by the monthly nurse giving the baby paregoric "on 
the sly," because she was tired of changing the napkins so often, the 



CONS TIPA TION. 101 



baby's bowels having been particularly free up to this time. I nursed 
the baby and was in perfect health, but never could succeed in so 
changing my own diet as to cause the baby's bowels to move spontane- 
ously . Finally the following very simple remedy was suggested to me 
by a physician, a friend of the family. Take loaf-sugar and dissolve 
in as little cold Avater as possible, thereby making a thick syrup. Give 
the baby one teaspoonful of this (or more as she grows older) immedi- 
ately before nursing, or feeding if bottle-fed . Be sure to give it before, 
not after, eating, as in the latter case the result is very apt to be a sour 
stomach. From the time I heard of this up to the present (she is now 
two years and nine months old) my baby has never had an enema, 
and by its use, as I believe, her bowels have been made as regular as 
could be desired. 

NeiO York E. C. C. 

The experience of C. M. C. of course justifies her aban- 
doning the suppositories. But, judging from considerable 
personal experience and the reports of many others, the soap 
rarely has such an effect. There are some persons (adults) 
so sensitive as to complain of being irritated by so unirritat- 
iug a thing as a well-oiled syringe nozzle, but this is rare. 
One source of irritation in the use of suppositories is the 
pressing too firmly in introducing them. If the point is in- 
troduced into the seat and a very little time is allowed to 
elapse before pressing further, the first spasm of the muscle 
relaxes and the pencil is readily introduced. The soap is 
often made less irritating by scraping it and forming a sup- 
pository of the scrapings. This is introduced easily and is 
not hard. We have never known real piles (as distinguished 
from an irritation of the anus) produced by the use of any of 
the suppositories recommended, but we accept our corres- 
pondent's diagnosis. 

The castile soap has theadvantage over other soaps of be- 
ing usually a well-made and bland soap and less irritating, 
and it is so far preferable. There are children, however, whose 
bowels seem to need the stimulus of the coarser variety. The 
candy suppository has "the wisdom of our fathers" in its 



N URsER Y PR OBL EMS. 



favor. It is quite useful for adults as well. Akin to the effect 
of eaudy is E. C. C. 's recommendation of syrup of cane-sugar. 
Owing to its tendency to sour we have suggested the use of 
malt in the food as a laxative, as we have found it to work 
well, and so far have not noticed the souring to follow. 

The regulation of the mother's diet is important. The 
friction and kneading of the bowels has some value. But 
in the regularity of putting the child upon the stool C. M. C. 
touches the most important point of all. Of course it is 
inapplicable to very young infants, but in adult life, as well 
as in childhood, the rigid following of this rule often cures 
constipation without any medicinal treatment at all. There 
is excellent physiological reason for it which we have no 
space to go into here. 



Water against Constipation. 

Will you tell me if I ought to force my six-mouths-old boy to 
take water frequently? He seems to dislike it, and always rights 
against it. 1 am careful not to have the water too cold, and have tried 
to make him take it from a spoon and from a tumbler. He has never 
had any food but breast-inilk, and is very constipated. I almost regu- 
larly use an enema of warm water. I am constantly afraid that this will 
injure him, but, after waiting two or three days, resort to it rather 
than to laxatives. I am perfectly well and strong, not subject to con- 
stipation, and have a good appetite, and drink no fluid except water. 
He seems to thrive on my milk, being always well and the picture of 
health. Will time and change of food cure him of constipation, and 
is it the result of his drinking so little water ? 
Baltimore, Md. R. P. 

No, he need not be forced. It would probably mitigate 
his constipation in part if he would take the water, but it 
is not so necessary at his age that you need fight it into him. 
The constipation probably will yield to change of food, but 
in the meantime you may feel clear that the enemas are 
less likely to do harm than the constipation is. 



CONSTIPATION. 



Magnesia as a Laxative. 

Is there any harm that can possibly be done by feeding magnesia ? 
I was advised to use it in the cream food in place of the lime-water 
on account of its laxative effect. Baby, eight months old, is badly 
troubled with constipation. I put about half a teaspoonful into each 
of the five or six feedings per day. 

Claremont, N. H. R. C. 

Magnesia is probably not so harmful as was formerly 
supposed. It is soluble and laxative only in combination 
with some acid, which acid may be met in the alimentary 
canal. The older physicians always gave warning of the 
danger of masses forming in the bowels. This may have 
occurred, but must have been very rare, as magnesia has been 
given very freely as a domestic remedy. On the other hand, 
it is not a desirable remedy. If a laxative antacid be desired, 
bicarbonate of soda has all of the advantages of magnesia 
without its alleged disadvantages. 



Constipation in a "Bottle Baby.'' 

Will you please tell me what I can do to relieve my baby of consti- 
pation ? He is four months old and has always been troubled with it. 
For a long time I was obliged to use a soap suppository or water in- 
jection very frequently. My physician at last prescribed castoria, 
but I find I must give it very frequently to keep the passage from 
being hard and balled. 

I have been obliged to use a bottle for him almost from the first. 
I have used cow's milk entirely for him. He has had a great deal of 
colic and indigestion, though he is relieved of much of that now, yethe 
still lias to be trotted and patted a great deal to get rid of the gas and 
sour milk in his stomach. 

I shall be very grateful if you can tell me of anything I can do to 
effect a cure of these disorders. 

.Sandwich, HI. M. It. S. 



104 NURSERY PROBLEMS. 

To answer off-hand is more than we can do. Constipa- 
tion is an extremely common ailment in infants, particularly 
if bottle-fed. How much you have diluted the cow's milk 
and with what we do not know. We may say, first, that 
the hard ''balled" passages are suggestive of an excess of 
casein, and the constipation would perhaps yield in part to 
the freer use of sugar and cream with the milk. So, too, 
usually the use of oatmeal gruel not too finely strained for 
dilution is often somewhat laxative. The colic, indigestion 
and constipation we take to be parts of the same derangement 
of the digestive process. 

As to medication we prefer for habitual use the introduc- 
tion of a suppository or an enema to the administration of a 
laxative. The soap pencil, the pencil of molasses candy, or, 
most efficient of all, the glycerine suppository, are very use- 
ful. Very often the most persistent care is necessary to keep 
the bowels relieved until the child is old enough to eat and 
digest a mixed dietary. We have followed a good many 
children who were troubled with constipation in infancy, 
and found them entirely and satisfactorily regular by two 
and-a-half to three years of age. 



Constant Use of Suppositories. 

Is there danger hi using suppositories almost daily to induce action 
of the bowels that the baby will get to depend upon artificial aid and 
thus fail to use necessary effort as he grows older ? 

Inexperienced. 

It depends upon the constituents of the suppositories. 
Simple cocoa butter, or the glycerine suppository, or soap or 
molasses candy suppositories we have never found harmful. 
As the child grows older and can properly digest a more 
varied diet, the constipation is likely to be cured. 



DIGESTIVE DIFFICULTIES. 



Trouble at Six Months. 

Our baby boy is five months and three weeks old. His mother's 
milk not agreeing with him, he has been a "bottle baby" from the 
first, and has always had a stomach and bowel trouble. It has been 
impossible to rind any food to agree with him for more than two weeks 
at a time. Besides the infants' foods sold by druggists, we have used 
sterilized milk, top milk and "cream food," and are now for the 
second time on top milk. "Whatever we give him has agreed with 
him at the start, and he has flourished for a few days, then he becomes 
fussy, his stomach sour, he is filled with wind and his bowel trouble 
increases — all this in spite of liberal use of lime-water. 

The bowel trouble, so our doctor tells us, is that somewhere, appar- 
ently where the small intestine enters the large, there is a failure of 
the proper secretions. The result is that the fseces stop there and 
harden into lumps, so that often the evacuation is attended with pain 
and only accomplished after severe straining. We have used glyce- 
rine suppositories, and they have helped ; we also use massage treat- 
ment and injections; besides this, we have used, for a month, under 
the doctor's instructions, physic — salts and a mixture of nux vomica 
and belladonna — in connection with his food. But the trouble is worse 
lather than better. He does not respond as quickly to the suppository. 
A larger amount of water is required in the injection, the lumps seem 
to form more constantly, a larger proportion of the faeces being lumpy, 
and his bowels seem to be more sensitive, for he will not sleep when 
before he would — that is, he wakes and requires to be relieved of 
lumps that before would not appear to trouble his sleep. During 
these six months he has had very few natural movements in which he 
has not required assistance. 



106 NURSERY PROBLEMS. 

He never has taken anything cold into his stomach, requiring all 
his drinks to he quite warm, and will strangle rather than swallow 
cold water or take his food even cool. He formerly would take any- 
thing we offered him between feedings — peppermint, warm lime-water, 
anise or warm water — but lately he has not been satisfied with, or will- 
ing to take, anything except food. 

He weighed 9% pounds when born, and now weighs 15)^ — both 
times without clothing. His flesh is hard and he is very strong, but 
lacks endurance. 

What do you suggest as to food, to treatment of the bowels, and 
as to the reason for the antipathy to cold drinks? 

Blue Hill, Me. D. 

First of all we must say that our advice is not in any 
way to displace that of the physician, which you will need 
to follow systematically ; but we may give a few hints of 
what occurs to us in reading your letter. 

You ask three different questions — (1) as to food, (2) as 
to the condition of the bowels, (3) as to drink. As no tem- 
peratures are given we interpret the phrases "cold" and 
"quite warm" in their ordinary sense — "cold" water of 
about usual drinking temperature when not iced, i.e., 40 to 
60 degrees Fahr.; "quite warm" as meaning considerably 
above blood heat. (We may mention in passing that it is 
not easy to estimate the value of these vague terras, as we 
see at table one person sipping with pleasure coffee or tea at 
a heat which is uncomfortable or painful to another. Many 
wish their coffee above 1 50 degrees Fahr., and almost any- 
one drinks it above 120 degrees, at least when first poured.) 
Starting with this premise, we would say that there is no 
reason why a child should like a drink much below 80 de- 
grees Fahr. unless he has become accustomed to it. Breast 
milk flows into the child's mouth at a temperature of about 
98 J degrees Fahr., or if the gland is actively secreting perhaps 
a trifle higher. This being the infant's standard, everything 
is regulated by it, and it is better that everything given to a 



DIGESTIVE DIFFICULTIES. 



young child should approximate this temperature. Attend- 
ants often err in making infant food decidedly hot, and 
presently Baby is brought by its hunger to tolerate this 
heat, and thereafter gets a habit of taking hot food. If this 
is so in your case, it would be a reason why a natural anti- 
pathy to cold drinks should be exaggerated. Moreover, 
if the child's food is given too hot, it may be a contributing 
cause to the condition of the bowels. We do not feel sure of 
our facts as to temperature, and so do not dwell on this ele- 
ment of cause. 

We have considered your third question first. The con- 
dition of the bowels appears to depend largely upon the 
question of food, and in answering your first question we 
shall mainly answer the second. When foods disagree, the 
cause may be some feebleness of digestive power, but much 
more commonly it is a faulty composition of the food or a 
wrong method of giving it. If the digestive power be really 
below the average, the food must be made as digestible as 
possible, and the digestion be aided by digestive ferments — 
pepsin, pancreatine, etc. — according to the views of the at- 
tending physician as to the special situation of the dis- 
ability. If the food alone or its administration be at fault, 
correction of these things will be sufficient. 

As to the present case, we may remark that no child of 
six months ought to have had so many foods tried upon it. 
Nothing can have been really and properly tried. The 
piopei way with any food which has a reasonable ground 
for being tried at all would be this : If after a while it seems 
(o disagree, try to find out why it disagrees and modify it 
accordingly. Such trials take time, patience and intelli- 
gence on the part of physicians and parents, but they ulti- 
mately succeed. 

The condition of the stools suggests that the amount of 
casein ingested is too great for the child's digestion. This 



N URSER Y PR OBL EMS. 



may be due to faulty composition of food or too large or too 
frequent meals, and, as before suggested, the heat of the 
food may have aggravated the trouble. As to Baby's un- 
willingness to take it at the proper temperature, only this need 
be said, a very little hunger will overcome his objection. 
Babies never deny themselves food to any dangerous degree 
on question of taste. 

We have not been able to answer your questions cate- 
gorically, but have given what hints we could. Among the 
foods that seem likely to succeed, we may mention milk pre- 
pared with peptogenie milk powder, the preparation having 
a larger proportion of water than is usually directed, given 
in small quantities. The medicinal treatment your physi- 
cian must direct in detail and step by step. 



Un assimilated Food. 

My baby, now ten months old, was a perfect picture of health 
until July, when, on account of the poor quality of my milk, I weaned 
her. Even while I was still nursing her, her passages were slimy, 
though of a good color. She is now almost worn to a skeleton. The 
doctor says her food does not assimilate, and we cannot find any food 
that nourishes her completely. Any food containing milk we cannot 
giye her. We have been in the Adirondacks all summer, and for a 
while she seemed to gain, and then would have diarrhoea more like 
dysentery, and that would reduce her again. Is there anything you 
can suggest that I might do? 

G. E. E. 

Where milk in its ordinary state cannot be borne, some- 
times preparations of milk (canned milk) or milk food 
(Nestl6's, for instance) will be tolerated. If not, then pep- 
tones of meat (such as Carnrick's or Sarcopeptones) may be, 
either when used alone or in soups or broths prepared in the 
usual way. There are many other things that may be sub- 
stituted, but for a child as ill as yours the dietary should be 
planned by your own physician. 






DIGESTIVE DIFFICUL TIES. 



Apparent Overfeeding. 

My little girl, four weeks old, seems to be troubled with indiges- 
tion. She spits up so much after nursing that it seems scarcely possi- 
ble that her stomach has retained any of the milk. Then almost im- 
mediately she is hungry again. I nurse her quite regularly every two 
and a half hours, and seem to have plenty for her. Sometimes the 
milk is curdled when she raises it, but more frequently not. 

She is troubled and restless after nursing, and often cries out 
when spitting up. She weighed 1% pounds when born, and now 
weighs 10% pounds. Her bowels are moved three or four times in 
twenty-four hours ; the color is good, but there are curds in the move- 
ments, and she almost always cries before the bowels are moved. 
Those I have consulted say, "spitting uj> makes a fat baby," and "it 
is healthy," but it- does not seem to me to be right. Can you advise 
what is best to do ? 

Princeton, X. J. F. W. R. 

The symptoms are very suggestive of over-distention of 
the stomach. A child at four weeks can rarely take com- 
fortably more thau two fluid ounces (four tablespoonfuls), 
and if your flow of milk is large, and particularly if it con- 
tain a good deal of solid matter — butter, casein, etc. — the 
regurgitation would very likely follow. If the trouble still 
continues we should see that she gets smaller meals. The 
repeated demands for food are the results of the indigestion, 
not of normal hunger. 



Indigestion. 

My baby boy is just six months old, has one tooth, and another 
visible. I nursed him partly until five months ; since then he gets 
pure cow's milk, sterilized, lime-water in every bottle, each bottle hold- 
ing six ounces. His meals he gets regularly, three hours apart. He 
has always, with the exception of the last few weeks, been well, his 
digestion having been perfect until lately, but now he has stool some- 
time < live and six times in twenty-four hours, and he has no appetite 
whatever; his sleep also has been restless since teething began. I am 



110 NURSERY PROBLEMS. 

much worried about the boy and would be very grateful to you if you 
could tell rue something that I could do for him in order to reli-eve his 
trouble. 

Ought I to put cream in his milk ; what can I do for his appetite ; 
must I change his food, and if so, what shall it be ? 

Chicago. E. S. A. 

A child of six months usually cannot safely take pure 
(«. e., undiluted) cow's milk. The average baby of twelve 
months finds it all that he can digest. You ought not cer- 
tainly to add cream unless to a much diluted milk. We 
favor " cream foods," but they are not made by adding 
cream to milk alone. One of the best has this composition : 
Milk, four tablespoon fu Is ; cream, six tablespoon fuls ; water, 
twenty tablespoonfuls ; milk sugar, a tablespoonful slightly 
heaped. After sterilizing, add two tablespoonfuls of lime- 
water. This, as you see, makes a pint of food. But you 
can probably do better than that now by simply diluting 
the milk with an equal bulk of boiled water, the lime-water 
to be included in this amount of water. Probably his ap- 
petite will improve when his dietary is more suitable. 



COLDS. 



Taking Cold Easily. 

(1) My baby nearly two years old takes cold very easily. I never 
know how. She perspires easily. When asleep, with only a little 
covering, her head will very soon be wet. Her feet, too, perspire easily; 
in fact, her stockings are almost always damp and her feet often cold. 
Of course I know she needs some constitutional remedy for this, and I 
do use something when she isn't taking other medicine for a cold, but 
is there anything I can do locally? 

(2) How long should she stay in her bath? She loves to play in 
the water and I want to give her the pleasure as long as I can. 

Osage, Iowa. Mother. 

(1) The two symptoms mentioned, sweating of the head 
and easily taking cold, are suggestive of that form of malnu- 
trition known as rachitis or rickets. If this exists, the 
remedy lies in nutritious and digestible food, cool sponging 
of the skin, and whatever else goes to make up sound 
hygiene. Sometimes tonics are needed. But the preventing 
of the colds by proper hygiene is far better than dosing for 
them. 

(2) Not long, we think. A good way to bathe her is to 
have her stand in a tub with enough warm (not hot) water 
tn cover the feet, while she is quickly sponged over with 
water of the temperature of 60 degrees or cooler. 



Fresh Air and Colds. 

I would like to know if a child six months old that has not been 
out of the house for many weeks ought, in your opinion, to be taken 
out during the winter on moderately pleasant days. The child is not 
very large or strong for her age, and is raised on the bottle ; she dis- 
charges from the nose as if she had a cold most of the time. 

(Mjden, Utah Ter. M. C. 



N USHER Y PR OBLEMS. 



The facts given are too few to enable us to answer defi- 
nitely, but from the following general remarks you may be 
able to make an application to your baby's case : In the 
first place, we do not believe in taking out children in all 
kinds of weather regardless of consequences, which is a part 
of the senseless " hardening " theory. The safe rule is, we 
think, tbis : Children ought to be regularly sent out except 
when there is rain, or when, by reason of great cold and 
very high wind, they cannot be kept comfortable. On such 
days we believe in the value of a promenade, the child 
dressed as for an out-door walk, in a room which has been 
thoroughly opened to the air. In this way it can get some- 
thing of a change without exposure. But there are some 
children who do not seem to do well if allowed to go out of- 
doors on any but the "bright and airless" days. This is 
particularly noticeable in the city when the streets are 
loaded with mud or slush, and we think evil effects are more 
noticeable in children who are old enough to walk than in 
infants. This maybe attributed to the inactivity of the 
children who walk slowly along on the sidewalks or are 
obliged to stand at street corners while a conversation is car- 
ried on by those in charge. The children whose animal 
spirits lead them into continuous romping out of doors suf- 
fer less. Be the cause what it may, some children, as we 
have said, do not well endure their daily walk, and are in 
less frequent need of medical advice when kept in on all but 
very fine days. Going out seems to keep them supplied 
with " colds " and other little ailments. But before the at- 
tempt to take the child out is given up one should make 
sure that the attendant inconveniences are unavoidable. If 
there were not so frequent an assumption to the contrary, it 
would be unnecessary to say that there is no deleterious ele- 
ment in out-door air that is not in in-door air ; our in-door 
supply must come from without, and we certainly do not 



COLDS. 



purify it in our dwellings. What we do avoid in-doors is a 
too low temperature and the violent force of winds and, to 
some extent, the all-pervading dust. 

If possible, let the child be carried. Your six-months' 
baby probably could be ; this gives her the warmth of the 
arms of the person carrying her. But see to it that she is well 
protected everywhere, not only about the head and trunk, 
but about the legs. Many a little child we meet whose legs 
protrude helplessly from its finery. If the child is in long 
clothes, let them be not too fine to be doubled up or folded 
around the legs. They are for warmth, not for decorative 
art. If it has reached the age of short clothes, and is to be 
carried, we prefer to knitted leggings, with the shoes pro- 
truding, a petticoat of short flannel or a blanket, sewed up 
at the bottom like the sleeping-bag of camp-life. This keeps 
the feet warm, while allowing the legs freedom of motion. 

A word as to the "cold." This term is so fixed in our 
speech that it is useless to quarrel with it. It is only necessary 
to mention here that the symptoms are not always, and per- 
haps not usually, due to the chilling of the person. And 
when the trouble is persistent, as in the present case, this is 
almost certainly not the cause. There may be a local cause 
in the nose, or the trouble may depend upon the feebleness 
of constitution of which you speak. Perhaps this feebleness 
is to some extent kept up by the child's lack of fresh air. 
At all events the cause of the discharge ought to be inquired 
into. 



Cold in the Head. 

My baby is almost nine months old and weighs about 20 pounds, 
exclusive of clothing. She seems strong and active, but has had two 
or three troublesome head colds and is inclined to constipation. She 
baa two teeth, which were cut without any trouble, is fed entirely from 
the breast, and usually takes six meals during the twenty-four hours. 



-Y URSKH Y PRO 11 1. EMS. 



(1) Our house is quite " drafty," so that Baby is kept a good deal 
in her high chair and carriage. Ought she to exercise on the floor? 

(2) Is there anything to do for a cold in the head except to apply 
vaseline about the nose and forehead ? 

Inexperienced. 

(1) It is not necessary for her to be on the floor, but she 
should have opportunity to use her limbs. The high chair 
is confining; the carriage is better. Why not let her play 
upon a bed with sides to keep her from falling off, which 
would be still better ? 

(2) Various solutions can be used in the form of spray 
from an atomizer. But you would better not select the solu- 
tion without medical advice. The vaseline should be used 
in the nose rather than around it. Warm the vaseline, and 
if you have no vaseline atomizer put it into the nostril with 
a soft camel's hair brush or by dropping in a little. 



"Starving a Cold." 

You would oblige me if you would state -whether a young child 
having a cold should be kept on a very plain diet while the cold lasts. 
Do you believe in what is commonly called "starving a cold"? My 
little five-year-old niece has been coughing for some time and looks 
pale, yet she is generally contented and happy. Would it be best to 
give her gruel, milk and water, etc., and but very little meat, while 
the cold lasts? Should she be kept very quiet and sleep as much as 
possible ? 

M. M. 

The proverb from which our correspondent quotes is 
quite as often reversed ; indeed, we first learned it, "stuff a 
cold and starve a fever." The question, as specifically put, is 
also too vague to be answered categorically, since so many 
ailments go under the name of "a cold." But we may 
answer in a general way thus : This child has been cough- 
ing for some time and has probably a catarrh of the throat 



COLDS. 115 



or windpipe. She is somewhat depressed by it, as shown by 
her paleness. As far, then, as the diet needs supervision, it 
should be with the purpose of securing good nutrition with 
easy digestion. The milk, if good, answers both indica- 
tions. The gruels, if milk-gruels, are also useful. If she 
can easily digest a little meat in the early part of the day it 
may be allowed, but it will not be needed if plenty of milk 
be taken. Good, nutritious broths, not greasy, are also 
good ; so sometimes are fresh eggs. It will be noticed that 
while the food in question is "light" in the sense of liquid, it is 
exceedingly nutritious and that it gives no endorsement at all 
of any starvation theory. Great Confusion exists popularly 
as to what is nutritious diet. Much food that would be very 
nutritious to a robust adult digestion is only wasted and 
irritating when put into a stomach that cannot manage it. 



Nasal Catarrh of Three Months' Standing. 

My little girl is now three months old and has been troubled with 
the "snuffles" since she was one week old. At night it troubles her 
very much and makes her restless. I have rubbed vaseline on her 
nose and inserted it into the nostrils, but without much effect. Can 
you tell me of anything that will help or cure it? 
Brooklyn. M. S. 

The treatment consists in keeping the child's general 
health in the best possible condition, and the avoidance of 
heated rooms, as well as of draughts and chilling, on the one 
band, and, if the trouble persists, in local treatment on the 
other. Hut practically, in a child so young, nothing can be 
done locally beyond careful cleansing of the nostrils. There 
are various Uinds of "snuffles," depending upon constitu- 
tional causes, which may be cured by. proper treatment. 



WHOOPING COUGH. 



Supposed Ignorance of Physicians Concerning 
Whooping Cough. 

Two of my children, one two years old and the other five, have 
had whooping cough rather mildly for the last two months, but I think 
they are on the mend. What would improve their case? 

I regret to say that the medical faculty do not seem to know much 
more about it than was known fifty years ago. 

Montreal, Our .) . W. N. 

Whooping cough is a disease if not of fixed, at least of 
prolonged, course. The "medical faculty" know a great 
deal more about it than they did fifty years ago. But medi- 
cal science usually does not, and we suspect will not, abbre- 
viate the course of diseases of an infectious nature after 
they are well begun. What has been accomplished in 
many of them is this : To recognize their natural career, 
the accidents and dangerous complications attending them; 
to point out the best means of avoiding or treating the lat- 
ter, and of mitigating symptoms and hastening conva- 
lescence. Most of all science has pointed out means of 
avoiding contagion. 

Now, as to the particular cases in hand. The children 
are mending, and in all probability will soon be cured. But 
we can offer you a few hints which may be serviceable. 
First of all, winter is coming and in your climate will come 
soon. It is very desirable not to enter the cold sea-son with 






WHOOPING COUGH. 117 



the bronchitis of whooping cough still lingering, because of 
its tendency to exacerbations and to chest complications. 
See to it, therefore, that your little ones are properly clothed 
from throat to foot, evenly, warmly, but not burdensomely. 
Try to keep your indoor temperature moderate (not above 
70 degrees, preferably nearer 65 degrees) and as uniform as 
possible. Regulate their outdoor clothing each day by the 
thermometer, which will probably vary a good deal in the 
coming months. Try to teach the habit of breathing 
through the nostrils, as mouth breathing is likely to excite 
cough in children recovering from whooping cough. Many 
little details will occur to you which we have not space for. 

Secondly, attend to the diet and to the digestion, as any 
derangement of the stomach aggravates the tendency to 
cough and to recurrences. If there is any marked dietary 
trouble medicinal remedies will be needed, tonics, 
stomachics, etc., according to the nature of the derange- 
ment. 

Beyond these points we need not specify, except that 
abundant and pure air in or out of doors is always a tonic. 
By pure air we do not mean harsh air, nor gales of wind 
which may bring anything but purity with them. 



Contagion of Whooping-Cough. 

I wish to inquire about whooping cough. Can it be carried from 
one child to another without the two children being together ? At 
what time in the duration of whooping-cough does one child give it to 
another ? 
Logan, Ohio. Subscriber. 

The poison, or contagium, of whooping-cough is gen- 
erally supposed to he very volatile, i. e., easily spread about 
in i he air. Ill oerefore is very easily contagious if a sufferer 
he brought oear others who are not protected, while for the 



118 NURSERY PROBLEMS. 

same reason the poison is thought not to cling to apparel, 
and hence to be not portable, at least any considerable dis- 
tance. The disease is communicable from a person as long 
as the cough continues. 



Severity of Whooping-Cough in Relation to Age. 

Does whooping-cough generally "go harder" with infants, say 
seven or eight months old, than with children somewhat older, other 
things being equal ? 

Manchester, Ky. \Y. 

We cannot answer the question in the precise form in 
which it is put ; that is, to say whether the severity of the 
disease is greater at seven or eight months than at a some- 
what later period, because we do not know how much older 
children you have in mind. This, however, we can say : 
The mortality from whooping-cough — doubtless chiefly from 
pulmonary complications — is much greater in young chil- 
dren than in those of what is called "the school age." In 
fact the mortality is chiefly under three, indeed even under 
two years of age. The actual per centum loss, however, in 
children of ordinary strength and well cared for, is not very 
great, although among the poor and neglected classes the dis- 
ease and its sequels account foran enormous total mortality. 
In the mild season the danger of pulmonary complications 
is less, and hence the danger from tbe disease is less. 



ERUPTIONS. 



The Characteristics of Mild and of Serious 
Eruptions. 



Is there any way of telling the difference between a little 
rash — heat rash, so called, for example — and that of scarlet fever, 
measles, etc. ? If it was the beginning of a severe case, of course the 
other symptoms would make themselves known ; but how would it be 
in a light case, and with an infant, who couldn't tell its feeling? 

I have a little nephew about three months old, who, when his 
mamma was just about to bathe him one morning, exhibited a slight 
rash. She was rather in a dilemma, not knowing whether it 
amounted to anything or not, and whether she should give the baby 
his usual hath and send him out for his airing in the carriage, or call 
in her physician. She finally decided that it didn't amount to any- 
thing, and her judgment in this case proved correct ; but think if she 
had been wrong and the result serious ! 
Jamaica Plain, Mass. A Seeker after Truth. 

The differences are not easy to describe in words, and it 
is said that in hot weather even physicians have mistaken 
German measles and some other eruptive disorders for 
prickly heat. The most striking distinction to the un- 
trained eye between scarlatina and prickly heat we think is 
the elevation of the eruption of prickly heat above the skin. 
It is composed of minute conical elevations with or without 
a watery liquid in a vesicle al the top, and the inequality 
can I"' recognized by passing the fingers over the surface. 
The eruption of scarlatina is made of minute bright red 



120 NURSERY PROBLEMS. 



points, afterward coalescing, appearing first on the neck, and 
then on the chest, and spreading, and brightest when 
covered. Measles has a duller red eruption, which appears 
in crescentic patches on the face first, and is brightest where 
exposed. German measles looks more like measles at first, 
and then more like scarlatina. Prickly heat is most abun- 
dant on or confined to parts where the clothing retains the 
perspiration. It comes almost exclusively in hot weather. 
The eruptive fevers are more prevalent in the cooler season — 
i. e., the season of closed and unventilated houses. 



"Driving in" Eczema. 

Is it really dangerous to try and heal eczema on a child's face? 
My baby was afflicted with it until eight months old, and I was 
warned not to attempt to heal it, as that would "drive it in" and pro- 
duce some form of sickness as a result. Our physician prescribed zinc 
ointment (which did no good) and said the ailment would probably 
last until Baby had all her teeth; then it would pass away. At Grand- 
mother's suggestion, however, I tried a mild solution of salt and 
water when washing Baby's face, following that each time with 
talcum powder, and this did more good than anything else. Then we 
went to the seashore, where Baby had the salt air and sea water for a 
final plunge after each bath (the chill taken oft' by the addition of 
plain hot water), and within a couple of weeks the eczema had disap- 
peared. We remained by the sea until Baby was ten months old, and 
the eczema has never returned in the same degree, but only in occasional 
patches during the cutting of a tooth or some little disorder of the 
stomach, such as babies have. If there is danger in curing the eczema 
ordinarily, why did no ill results follow the natural cure performed by 
the sea ? A . Z. 

There is no danger whatever in treating an eczema ; it 
cannot be "driven in." The blunder — a very wide-spread 
one popularly — came about thus : Eczema sometimes de- 
pends upon constitutional conditions that vary their points 
of manifestation ; when a new point is attacked, the eczema 



ERUPTIONS. 121 



sometimes disappears. So, too, it is a very common obser- 
vation that two diseases rarely will go on actively at the 
same time ; hence it has been observed that an eczema has 
disappeared when an internal disease in no way connected 
with it has been set up. In such cases the eczema might be 
said to be "called in." 

Eczema and other skin diseases should be always healed 
as soon as practicable. The notions about "driving in" 
eruptions are ordinarily simple superstitions, and at best 
are founded on the misapprehension of cause and effect. 
When a severe illness occurs eruptions sometimes fade, and 
the careless observer thinks that the illness was caused by 
the disappearance of the skin disease, when the reverse was 
the truth. We may, however, say that such eruptions are 
often very obstinate and hard to cure. 



Heat-Rash. 



My little girl, twenty months old, is much troubled with heat- 
rash. "We bathe her with bicarbonate of soda and water, and use 
zinc or lvcopodium powder ; but neither seems to do her any good. 
Can you recommend any different treatment? Would it be well to 
use vaseline ? She has lately been having a good deal of bowel and 
stomach trouble ; but that is accounted for by the fact that she is just 
getting her stomach and eye teeth. We feed her, by our doctor's ad- 
vice, on oatmeal gruel and milk entirely. Is barley equally nutri- 
tions, and would it be less heating to her blood ? Would it he well 
for her to wear linen or lawn next her skin under her thin merino 
shirt? The rash usually conies out on her face and neck with every 
warm spell, but this time it is all over her body and I don't know 
what to do for it. 
Georgia. Makietta. 

Derangement of the digestive tract often increases the 
susceptibility of the skin, and anything that relieves the 
former will in so far help the other. .Just what things your 



NURSER Y PROBL EMS. 



child needs in this May your physician can best say. The 
heat-rash is usually kept up by the excessive perspiration, 
and the lessening of the latter is also helpful. Limiting as 
far as possible the child's activity of course will diminish 
perspiration ; sometimes the use of alkaline drinks is useful, 
but they should not be employed without the consent of the 
physician who is familiar with her stomach trouble. Again, 
light and loose clothing — which may at the same time be 
sufficiently warm to prevent chilling — is very useful, the 
worst irritation from heat-rash usually being at points 
where the clothing binds. The lawn or linen shirt under 
the merino is often useful in allaying friction. Barley is of 
about the same nutritive value as oatmeal, but less laxative. 
Some persons find oatmeal " heating," in the sense of favor- 
ing eruptions. 



Red Gum. 



My baby-girl is six months old to-day. She is plump and 
usually good. At the age of two months she had red gum, and it was 
some weeks before she recovered. It, the rash, remained the longest 
and brightest wherever the wet napkin touched, and even yet comes 
and goes there. An orange stain is often present. The opening into 
the bladder is also a bright red. She has been of a very constipated 
habit, but by giving her a little " brown-bread coffee," I now secure a 
daily movement. I have been able for over a month now to see four 
teeth, the upper front ones, but they are not yet through. 

My hope is that you can give me definite directions as regards her 
urine, and also tell me when and how I had best wean her. 1 have 
plenty of milk, when I can get it myself to drink (just now the people 
with whom I am boarding have but little), and have nursed her regu- 
larly until six weeks ago, every two hours in the day — once at night — 
and since then every three hours. 

Montgomery Centre, Vt. F. J. 



ERUPTIONS. 



The "red gum." and the present rash, are not, strictly 
speaking, the same, but that is a point of small moment. 
The eruption under the napkin is very common, especially 
if the urine be very acid, as it probably is when the orange 
deposit is present. To correct this tendency (which is prob- 
ably due to peculiarities of digestion) in a child on the breast 
is not easy. Something may be done by giving her water, 
and we think the condition will probably improve, since 
you have adopted the three-hour rule in place of the two- 
hour interval, which was continued rather long. Locally, 
washing the parts with weak alkaline washes — e.g., lime- 
water, or very weak soda solution— will allay irritation. If 
the skin is irritated, great care should be exercised in 
cleansing the parts frequently, carefully drying them and 
powdering or dusting them with fuller's earth or similar 
preparations. 

"Black-Heads." 

1 wish to ask your opinion regarding a certain condition of the 
skin which is unpleasant to behold. I refer to the choking-up of the 
little glands on the forehead and around the mouth, which become 
blackened and are known as "black-heads." Then the pores of the 
skin of the nose are enlarged and minute fatty particles can be pressed 
out. This gives to the skin a greasy look. I have asked a physician 
about the cause, thinking perhaps it was an impurity of the blood. 
Buthe claims it is not, and that he knows of nothing to remedy it. 
I have kept the pores of the skin of the whole body open by fre- 
quent bathing, thinking that might be of benefit. Sometimes she 
has little elevations which are like little pimples, but when they are 
squeezed out it is just the same fatty substance which exudes — not 
pus. I would state that her diet has been carefully watched and only 
the simplest food allowed. Are these appearances of the skin, espe- 
cially the little fatty pimples, due to the state of the blood ? What 
course of treatment could you advise me to pursue in order to have 
the pores of my little girl's face clean, pure, and healthy ? 

Ohio. A FiiiKMi. 



124 NURSERY PROBLEM*. 

The ailment is easily recognized. The medical name of 

the eruption is comedo. The natural sebaceous follicles are 
filled or distended with their secretion (sebum), and the 
dark head is caused by the deposit of dust, or possibly, as 
some think, by a formation of pigment. The situations most 
generally affected are the nose and its neighborhood, the 
forehead and temples, and the upper part of the back. 

Constitutional treatment is sometimes necessary, but 
ordinarily purely local treatment suffices. It consists first 
of squeezing out the contents of the follicles. This may be 
done with iinger-nails, better by means of a large watch- 
key, or, still better, a small cycliudrical tube with a smooth 
end, which is less likely to injure the skin. The hollow end 
is placed over the "black-head," and smart, abrupt pressure 
forces the latter out of the follicle. 

Directly after the use of the instrument on the various 
points the parts are to be bathed with hot water to diminish 
the irritation. In addition, the glands are to be stimulated by 
the daily use of good soap. If this proves too irritating, 
warm bran-water in which a little borax is dissolved may be 
used. If the skin is unpleasantly shiny after the use of 
soap, rub it with a soft flannel or lightly powder it. But, 
except among ladies, this shininess of the skin is rarely 
considered worth notice. 



Hives— The Cause and Cure. 
Will you kindly tell me if there is any cure for hives '.' I have a 
little boy, now eighteen months old, who is perfectly healthy in every 
respect, but is greatly troubled with hives, and has been since his 
birth. He has been raised on condensed milk, Eagle brand, and has 
only commenced to take solid food within the last two months. I 
can't observe that his diet has much to do with it. He appears to 
inherit the trouble from me. 

Oakland, Gal. C. S. B. 



ER UPTIOXS. 125 



It should be mentioned that the terni " hives " is a pop- 
ular name for several disorders of quite various character. 
First, it means croup, especially catarrhal croup. This ap- 
plication of the term seems to be not common in America, 
but it survives in the popular remedy for croup now passing 
out of use — "hive-syrup." Secondly, the name is applied 
to various skin eruptions, aud particularly to urticaria, or 
nettle rash. In answering we shall assume that this is the 
disease meant by our correspondent. 

Both the scientific and popular names just mentioned 
are derived from that of the stinging nettle (several species 
of urtica), which produces this eruption if it touches the 
skin, at least in man}' persons. The eruption is composed 
of wheals, raised above the surface a sixteenth of an inch or 
more, which are white or pink and surrounded by a red 
blush. Ordinarily thej- are not much larger than a finger 
end or a cent ; in severe cases they form large patches, and 
it is Dot rare to see the face swollen by them until it resem- 
bles the face of one afflicted with an erysipelatous inflam- 
mation. The outbreaks are usually quite suddeu, and often 
they as quickly subside. Many persons are very subject to 
the disorder, particularly those of a nervous temperament. 

The causes are very various. External irritations of 
many kinds may excite it Beside the nettle, which stings 
by its minute sharp hairs, many stinging insects cause it. 
A stroke of a whip-lash is a well-known instance of an ex- 
ternal irritant causing the wheal. We have seen persons 
whose skin, particularly after a bath, would rise in the track 
of a simple pressure of a finger-tip. The skin of some per- 
sons is chronically in this state of excitability. 

Internal causes are also very various. Most common of 
all is a sensibility to certain thin.irs taken into the stomach, 
Some of which affecl many persons. Of these the most fa- 
miliar are fish, oysters, clams, lobsters, crabs and berries, nota- 



N URSER Y PR OBL EMS. 



bly strawberries. Less frequently vegetables, such as cucum- 
bers and mushrooms, may be the offending food, and some 
persons are affected by eggs or honey. Many persons are 
affected only at certain seasons or occasionally, others pretty 
uniformly by some particular article of diet. The peculiar- 
ity does not seem to be always connected with an indiges- 
tion, as the effect is sometimes too prompt, occurring almost 
before the food is swallowed. There are mauy drugs which 
produce urticaria in susceptible people. 

Now, to effect a cure is often extremely difficult ; often, 
on the other hand, very easy. This depends in part upon 
the varying character of the ailment as to pertinacity and 
upon the good fortune of the physician in ascertaining what 
is the particular cause in any given case. The successful 
remedies may, for the greater part, be classed under three 
heads: (1) Those which clear the intestinal canal of the 
offending substance, if food seems to be the cause of the 
trouble. The household remedy of rhubarb and soda, or 
rhubarb and magnesia, maintains its place among such. (2) 
Remedies which act as antiseptics upon imperfectly digested 
or fermenting food. Among the most popular of these are 
sodium salicylate and sulphurous acid, or the sulphites. (3) 
In cases more or less chronic, tonics, especially Peruvian 
bark and its derivatives, are very useful. 

For the temporary alleviation of the itching, sponging 
with alkaline solution (soda and water) or with alcohol or 
the rubbing on of an ointment containing chloroform seems 
to be as successful as anything we know. 

The main point, however, is to find out the cause, and 
in the case of your baby we think the most probable source 
of mischief lies in the intestinal canal. An occasional clear- 
ing out of the bowels with the rhubarb and soda, and pos- 
sibly a tonic, will be the safest plan. 



MINOR AILMENTS AND TROUBLES. 



Excessive Sweating of the Head. 

My baby is six months old, and kept remarkably fat during the 
intensely hot weather. She suffered little from the heat, but her head 
was covered with big drops of perspiration when she ate and the pil- 
low on which she sleeps was saturated. As yet she has no teeth. I 
read that three grains of phosphate of lime twice a day would prevent 
the perspiration on the head. "Would you advise giving it, and do 
you think she is old enough to have trouble in cutting her first teeth ? 
Memphis, Tenn. M. G. C. 

She is old enough to be getting teeth, but there is no 
particular reason why she should have trouble in doing so. 
They may be late. If the sweating occurs in any but very 
hot weather the phosphate of lirne would probably be of use, 
but we presume that a preparation of the hypophosphites 
would be better. 



Cold Feet as a Consequence of Short Clothes. 

Can you tell me how to keep my little girl's feet warm through 
the day? She is eight months old, has always been strong and well, 
is plump, and has rosy cheeks. I put her into short clothes a month 
Bgo, i .11 1 ting on long woollen stockings and the little soft, solid shoes 
that come for the first wearing. At night, when I undress her, her 
little feet are very cold and clammy. 
Haverhill. Mass. 8. 



128 NURSERY PROBLEMS. 

It is not very easy to keep the feet of a baby quite warm 
who is short-coated in winter. The first effect of shoes is 
rather to retard the circulation in the feet by diminishing 
the play of the muscles. Little ones who are very vigorous 
often have the feet and hands considerably colder than the 
body or the limbs. The best way we know is to have the 
shoes and stockings very large, to make sure that the feet are 
quite warm when put into their coverings, and if this alone 
does not succeed, to take off the shoes and stockings in the 
middle of the day, rub and warm the feet, and reclothe 
them. See also that the napkins are not so tight as to pre- 
vent exercise of the limbs. 



Sore Mouth. 

My baby is troubled with a very sore mouth, which is exceedingly 
painful when she drinks. I have heard of bottle babies Buffering 
thus for months, the ulcers often leaving scars for years. Is this the 
common fate of all poor babies who must nurse from a bottle, and is 
there no preventive or cure ? It seems to be a rubber poison. I have 
read of silver and porcelain nipples, but have been unable to find any. 
Do you know where such articles can be purchased ? If I can get any 
help from you for these troubles I shall be very grateful. 
Spencer, Ind. M. P. 

It is not the "common fate" of bottle babies. Some 
babies who are feeble get sore mouths, whether on the dottle 
or the breast. The commonest cause of sore mouths is 
neglect of the details < »f tidiness. The rubber nipples should 
be carefully scrubbed and cleaned, and such cleansing would 
be just as necessary if you had metal, porcelain, or even 
glass nipples. Besides, the child's mouth should be cleansed 
before nursing, and quite thoroughly after nursing, if a 
tendency to sore mouth exists. Ordinary borax or boric- 
acid solutions are good, but others are used according to the 
condition of the mouth, as directed by the physician. 



MINOR AILMENTS AND TROUBLES. 129 

Metal and porcelain nipples are objectionable, especially the 
metal, even if they can be obtained. We have not seen one 
in a great while. The old ivory mouth-piece, too, has gone 
into deserved retirement. Rubber nipples of good quality, 
if properly cared for, will give you little trouble, we think. 



Coated Tongue. 

My two little girls have always been very healthy children, 
neither having had even the common eruptions or rashes incidental to 
infancy ; but the elder, three years and a half old, has always had a 
white-coated tongue, except at very rare intervals. She is the picture 
of fair, robust, rosy childhood, perfectly sound in every way appa- 
rently. Can you account for this seemingly incongruous case? I 
sometimes feel anxious about it, as such a tongue is usually regarded 
as indicating a disordered stomach ; but this cannot be so, as I am and 
always have been particular as to food, regular hours and habits, 
clothing, etc., which are such as I think you would approve of. 
St Joint, X. B. E. B. H. 

We cannot, of course, tell why the child's tongue is 
white. It is noticeable in some children and adults with- 
out any corresponding symptoms of stomach disorder. And 
we have noticed that some persons when using a milk diet, 
even if with pleasure aud apparent benefit, have a slight 
whitish coat or coloration upon the tongue. If you can find 
mi other evidence of ill-health we think you may safely dis- 
regard the symptom, 



"Three- Months' Colic." 

Please tell me something about the legitimate remedies for "three 
months' colic" in infants. I am entirely without experience, and, 
with the advice of nurses, friends, and doctors, have rung the changes 
on "Dewees's Carminative," catnip-tea, soda-mint, gin and fennel, etc. 
Are these all harmful '.' 
New Orleans, La. B. 



130 



N URSE R Y PR B LEMS 



Catnip-tea, given hot, and soda mint, dissolved in hot 
water, are both safe and useful in relieving colic. But it is 
best to search for causes. Children have colic at all ages. It 
is, perhaps, more frequent at the age mentioned than 
earlier, because the little one has gained more independence 
of action, kicks its covers off and so gets chilled, and is 
in warm climates or seasons often placed upon the 
floor. Besides— and perhaps this is most important of all- 
certain processes of development in the intestinal canal 
make the child at this age more susceptible to derangement 
from all causes. A child that has shown the colicky ten- 
dency should be carefully protected about the bowels at all 
times ; should not be allowed to become constipated ; if fed, 
should have its food prepared with great circumspection ; if 
suckled, its mouth and the nipple should be kept particu- 
larly clean to avoid any source of fermentation which might 
act upon the milk. 

Colic and Teething. 
Will cutting the lateral incisors give a baby colic? It seems to 
in the case of my baby, ten months old. I give her capsicum tablets 
for it. Is there anything better that you can recommend ? 

Nahant, Mass. M - B - H - 

The cutting of teeth is charged with many digestive dis- 
orders. The latter are, however, now attributed, by those 
giving attention to such things, more frequently to changes 
in the development of the digestive organs which occur at 
the same period with teething. It is, therefore, safer to say 
such symptoms accompany rather than depend upon teeth- 
ing. Capsicum, the oils of mint and anise, in the shape of 
cordials, or the tincture of the drug-shops— a few drops in 
hot water— and many other things will relieve colic. Hot 
water alone is often efficient. Better is it, if possible, to re- 
move the cause. 



MINOR AILMENTS AND TROUBLES. 131 

Colic Accompanying Nursing. 

"What is the cause of my baby-girl, two-and-a-half months old, 
having colic when she nurses ? She may have been perfectly quiet 
before she began, and oftentimes will only take one or two swallows 
when the colic strikes her, and it is only by working with her for some 
time that she can get enough to satisfy her. The only time that she is 
not troubled is the one time that she nurses during the night. 

Two physicians have given her simple remedies for indigestion, 
but they had no effect; others said the milk came too fast, but the 
above sentence disproves that, as naturally at night it comes faster 
than at any other time. Can you tell me what the cause is ? She 
sometimes sleeps the whole morning, and anyway is nursed only every 
two-and-three-quarter hours, yet always has it. Have you ever had a 
similar case? I have not met any one that had ever heard of it. I 
am not alarmed about it, but I should like to know something to re- 
lieve her at that time when she ought certainly to be easy. She is not 
one bit sick, but, on the contrary, is thriving nicely. 
St. Louis, Mo. A. 

Such cases are by no means rare in infancy or in later 
childhood — that is to say, the taking of food into the 
stomach excites prematurely the stomach and intestines to 
action. We do not know enough of your condition of health 
or of your baby's to tell you what is the exact cause in this 
case. Sometimes the trouble is due to over-irritability of the 
digestive tract in the child, sometimes to some unsuitable- 
ness of the food — milk, or whatever it may be. In older 
children, as well as in infants, it is not rare to see a meal — 
whether from breast, bottle, or from table — frequently or 
even usually interrupted by a movement of tbe bowels. 
Doubtless your baby's case belongs to the same group, al- 
though the effecl seems to be limited to colicky pain. The 
fact that the disturbance is less marked at night does not 
quite clear up the matter, because your milk might be better 
for your lest, or I iaby's digestion better for her rest. Take 
one of your two physicians and let him follow out the 
matter. 



132 NURSERY PROBLEMS. 



The Cause and Cure of Hiccough. 

My baby, a little girl now seven and a half months old, has 
always been troubled with hiccough. For the first three months her 
food was what nature provided ; then that proved insufficient, and the 
insufficiency was made good by cow's milk, upon which she ha* 
thrived. It is now her only food, and she is healthy, hearty and 
happy, but is troubled very often with hiccoughs. She has them as 
often as four or five times some days, and perhaps next day will not 
have a single attack. She is now fed at intervals of four hours during 
the day, and gets one light meal at night. 

I have sought information of my nurse and of persons who have 
had large experience with children, and have received the uniform, 
highly unsatisfactory reply : "Babies who have hiccoughs always 
thrive." Can you throw some light on the probable cause and sug- 
gest a remedy? I have used liquor of pepsin, sugar and sweetened 
water (both warm and cold). They give only temporary relief. I 
would like to strike at the root of the matter. I hope your reply may 
help other inexperienced mothers. 

Cedar Rapids. Inwa. L. H. D. 

Hiccough is a spasmodic contraction of the diaphragm, 
which arises from a multitude of causes. While in some 
diseases it is a grave symptom, it is usually only a passing 
annoyance, and of this type is common hiccough of babies. 
The real physiological reasons of hiccough are not well un- 
derstood, but the exciting causes are. For babies the com- 
monest causes are simple over-fulness of the stomach, or 
pressure upward of the stomach or abdominal organs from 
any cause (tossing the baby or a sudden motion from alarm 
may excite it). What the particular cause in any given case 
is, only a close observer of that case can tell. 

Some of our correspondents have commented on the 
value of crying as a remedy. Recently in several medical 
journals the fact that sneezing is a cure has been discussed. 
The explanation of both seems to be this: Hiccough is a dis- 
turbance of the ordinary respiratory movements ; so is 
sneezing and so is crying. If the one disturbance comes on, 



1IIX0R AILMENTS AND TROUBLES. 



the other ceases. Every one must have noticed the similar- 
ity between hiccough and the violent sobs following a hard 
fit of crying with some children. It is not necessary that a 
person actually sneeze to produce the desired effect ; tickling 
or gentle irritation of the nasal mucous membrane is usually 
enough to stop the hiccough. 

This remedy, it has been pointed out by Dr. Gibson, is 
as old as Hippocrates, who says : "Sneezing occurring after 
hiccough removes the hiccough." Dr. Burnett, in a letter 
to the Medical. Record, says : 

" When devoting a leisure hour to Plato's Dialogues, as 
translated by Jowett, I was struck by a passage in the Sym- 
posium which had never arrested my attention before. Trans- 
lated by Jowett, it stands thus : ' When Pausanias came to 
a pause, Aristodemus said that the turn of Aristophanes was 
next, but that either he had eaten too much, or from some 
other cause he had the hiccough, and was obliged to change 
with Eryximachus, the physician, who was reclining on 
the couch below him. ' Eryximachus,' said he, ' you ought 
either to stop my hiccough or to speak in my turn until I 
am better.' 'I will do both,' said Eryximachus. ' I will 
speak in your turn, and do you speak in mine ; and while I 
am speaking, let me recommend you to hold your breath, 
and, if tbis fails, then to gargle with a little water* ; and if 
the hiccough still continues, tickle your nose with something 
and sneeze; and if you sneeze once or twice, even the most 
violent hiccough is sure to go. In the meantime I will take 
your turn, and you shall take mine.' ' I will do as you pre- 
scribe,' said Aristophanes ; 'and now get on.' 

"The hiccough was not cured by the first nor by the second 
remedy suggested by Eryximachus, but by the production of 
sneezing. The method of tickling the nostrils lias been tested 
by us in cases of Obstinate hiccough, and has been very sue- 



N URSER Y PR OB L EMS. 



cessful. It is not necessary that the stimulus applied to the 
nose be followed by sneeziug ; the application of a gentle irri- 
tant to the nasal mucous membrane may lie quite enough to 
put a stop to the hiccough, by diverting the nervous energy 
into other channels although it may not be of sufficient 
power to induce sneezing." 



Need all Children Hiccough? 

Do all babies have hiccough? I have three, and they all have 
had hiccough more or less. They have l>een exceptionally free from any 
digestive disturbance, outside of that ; their bowels have been regu- 
lar, they have had red tongues, sweet breaths, etc. It has only been 
as tiny babies that they have had hiccough ; but I have wondered 
sometimes if there ever was a baby so perfectly managed that it never 
had this sign of indigestion. 
Boston, Mass. Hiccoughs. 

Probably all or nearly all babies have had hiccough at 
some time, while only a minority have the symptoms often 
or habitually. We cannot even admit that it is always a 
sign of indigestion. If you notice the troubles that excite 
hiccough in larger children or adults, you will see that it is 
not usually caused by indigestion proper. Over-distention 
of the stomach, and, perhaps, more commonly too rapid 
eating bring on this peculiar spasmodic action of the dia- 
phragm. 



Excessive Nose-Bleeding. 

My baby, six months old, had a severe attack of "nose-bleed." 
She woke from a sound sleep, and blood commenced flowing and con- 
tinued for some ten minutes. Is such an occurrence a rare thing for an 
infant? or does it indicate some serious trouble? She was perfectly 
well before the attack, and seems so since. Can you suggest a way to 
stop the flow should it again occur? Our family doctor says he 
never knew of a similar case, and volunteers no opinion. 
New York. Inquirer. 



MINOR AILMENTS AND TROUBLES. 135 



It is an unusual case. If it recurs, the safest and 
quickest remedy we can suggest is syringing the nose with 
quite cold or hot water. A hot solution of alum is also 
quite efficient— a teaspoonful of powdered alum to a pint of 
hot water. If it should again occur, however, the nose 
should be examined thoroughly to see if any local cause— a 
small sore or anything of the kind — exists. This is some- 
times the case, and a little local treatment may save much 
bleeding, which is particularly desirable, as babies feel the 
loss of blood relatively more than adults. 



Gritting the Teeth; Worms. 

My baby grits his teeth terribly when asleep at night. His grand- 
mother and I have thought he had worms, and I have given him sev- 
eral enemas of strong salt and water, but I have seen nothing that 
looked to me like a worm. His seat has been broken out and has 
itched fearfully, and the enemas seem to have benefited both these 
troubles ; at least they have disappeared. Of late Baby's urine has 
looked rather greasy on the surface. He is apparently in perfect 
health, but has a very small appetite, and would starve before he 
would eat really proper food. Whether this be so or not, he seems to 
crave "grown-up" food and digests it perfectly. He is two years and 
eightmonths old, was nursed till sixteen months, and carefully fed till 
after two years old. He has always been well and strong, but not very 
fat. Now he eats almost what we do, and is growing fat and rosy. 
The only trouble he lias is this appearance (to me) of worms. Do you 
think we are right in our theory, and what do you recommend ? 
New York. An Anxious Mother. 

I 'fitting the teeth in the sleep is not necessarily, or even 
usually, a sign of worms. It may proceed from any irrita- 
tion, very often in the digestive tract. If a child shows the 
condition of mine you describe, we should look for digestive 
derangement ; tins, added to the eruption on the seat and the 
gritting aforesaid, make a strong probability that he is suf- 
fering as mighl be expected of a child of his age who takes 
"grown-up" food. Cf he is pul upon a proper diet, irre- 



A" I 'USER Y PROBLEMS. 



spective of his notions, he will presently yield the point and 
eat what he can get. It is, however, cruel to expect a child 
who has been indulged in this respect to sit at the same 
table with you without demanding your diet. He ought to 
be fed before your meals, and by himself. 

We are often at a loss to guess what is the standard of 
perfect health used by many persons. Your child is so de- 
scribed. Yet you mention small and capricious appetite, 
disordered urine, a skin-eruption and disturbed sleep as the 
source of your anxiety about him. 

Persistent Itching of the Nose. 

Our little girl of fourteen weeks is terribly troubled with an 
itching nose. Can you suggest the cause or remedy ? She is a plump, 
strong and rosy-cheeked baby, and has never had anything but 
breast-milk until two weeks ago ; at that time she was very 
constipated, with curd in the passages, and the physician advised giv- 
ing her two meals per day of Mellin's food; she has five meals, three 
hours apart; she does not nurse at night; the food now seems well 
digested, and she has one good passage a day. She often wakes crying 
and trying to rub her nose on the blanket, and when lying on her side 
will turn over on her little face and rub it back and forth on the pil- 
low. Her face has had scratches nearly all over given by the little 
fingers, aimed for her nose. As soon as it begins to itch badly she 
wants to nurse and will suck her fist with great gusto. The doctor 
thought it some kind of abdominal irritation and gave her medicine 
which does no perceptible good. He thinks her too young for 
worms. She has had this trouble ever since she was old enough to 
make any attempt to rub her nose, perhaps five or six weeks ago. Do 
you think it can be worms, and is she too young to take worm medi- 
cine ? She "drools" a great deal and bites my fingers very hard when 
I wash her mouth, though there is no sign of teeth. She has 
been almost spoiled the last few weeks out of our sympathy for 
her trouble, which wakens and worries her at all hours of the day or 
night. I have tried every way I could think of to chafe her nose, 
using my hand, a coarse towel, her hair-brush, etc. If you can 
give me any light on the subject I shall be deeply grateful. 

San Jose, Cal. F. H H 



MINOR AILMENTS AND TROUBLES. 137 



It would be well first of all to see if there is anything in 
the child's apparel that might cause the itching. Some 
fabrics, as, for instance, the " squirrel's-fur " yarn, have a 
light nap, which is easily detached, and excites, by being 
inhaled, great irritation of the nose. Still in this case, if we 
must hazard an opinion, the trouble is probably due, as the 
physician suggested, to some "abdominal irritation." The 
presence of worms is not probable, and we may say that the 
itchiug of the nose, which is so often pointed out as a symp- 
tom of worms, is due, we believe, not to the presence of the 
worms themselves, but to the co-existing intestinal dis- 
orders. As to treatment, we would suggest that the chafing 
of the nose be done as little as possible, but that soothing 
applications be used. Very weak solutions of carbolic acid 
have been found useful ; so, too, have solutions of bi-carbon- 
ate of soda and many other things which your physician 
can suggest. Above all persist in your attempts to discover 
the digestive disorder which probably lies behind the irrita- 
tion described. 



Swollen Tonsils. 

My little boy, who is just four years old, is troubled with swollen 
tonsils. During sleep he snores distressingly, and he has frequent 
colds in the head. Our physician thinks it would be best to cut the 
tonsils, but I dread the operation, and many friends, some of them ex- 
perienced mothers, warn me against allowing the operation to be per- 
formed. They tell me that he may outgrow the trouble; that the op- 
eration, performed at this early age, might have to be repeated, and 
that, as he is the picture of rosy health, the swollen tonsils and 
labored breathing at night cannot be doing him any injury. I am 
very much troubled about the matter, and am anxious to have your 
advice. Does this condition of the throat predispose to diphtheria? 
What home-treatment would you suggest to diminish the swelling? 
New York. A. A. M. 



138 NURSERY PROBLEMS. 

Of course it is impossible for us to give an opiuiou on 
this or any other particular case ; but in a general way some- 
thing may be said. Even if the phrase "swollen tonsils" 
be limited in meaning to express only a condition of some 
duration, it does not always mean the same thing. In 
health the tonsil is very small — so small that some who 
have studied throat diseases particularly think that it does 
not exist in the sense of being a visible prominence. Now, 
when the tonsil becomes enlarged and remains so it may be 
from removable causes and conditions, or it may not. 
Stripped of all technicality, the one group of cases may be 
considered as those in which much of the enlargement is 
due to an excess of blood in the tissues, and the other group 
embraces cases in which actual overgrowth of the tonsil has 
occurred. In the former cases the enlargement may dimin- 
ish until the tonsil, while still larger than proper, gives no 
very great trouble. In the latter the most experienced ob- 
servers doubt if any treatment short of removal of the tonsil 
by some means is of much value. The popular ideas about 
outgrowing the condition are based partly upon the false 
assumption that what is really a considerably enlarged ton- 
sil is the natural state of things, and partly upon the in- 
ability of non-professional observers to distinguish between 
the temporary swelling of the tonsils, the chronically en- 
gorged tonsils, and the really overgrown tonsils. Now, the 
opinion of the most "experienced mother" can be of no 
value here. She cannot, at the outside, have seen more than 
two or three cases of the last-mentioned variety. It is fair 
to presume that if you have a family physician you have 
chosen him because you believe him to be skilful and con- 
scientious. That being the case, it is probable that such a 
man would not advise cutting off the tonsils if he believed 
he could accomplish a cure by any less severe method. If 
you are not content to rely on his judgment alone, get that 



MINOR AILMENTS AND TROUBLES. 139 

of another physician, but do not ask or accept lay advice. 
So much for the "outgrowing " of the disease. As to the 
need of repeating the operation, only this need be said : 
The operator does not undertake to put the patient in better 
health than he had before the disease began. It is very 
common to find people who suppose that after an operation 
they can with impunity follow the same faulty course of life 
that originally caused the disease for which the operation 
was made. If the tonsils are removed the same care must 
be observed to prevent new trouble as would be requisite to 
cure the enlargement if it were of the kind curable without 
operation. As a matter of experience, however, it is true 
that if the tonsil is thoroughly removed at first a second 
operation is rarely, if ever, required. "Outgrowing" the 
disease is a bad name, since it conveys the idea that the 
simple lapse of time and increase of stature are sufficient 
for the purpose. This is only the case when improved 
health comes with the lapse of time. And in this disease 
this improvement is the result of very persistent watching 
as to all the details of hygiene, local and general, in the 
widest sense- of the word. 

This may sound strange as applied to one who is the 
"picture of rosy health," but we have so often heard this 
epithet applied to children who did not at all correspond to a 
physician's idea of health— indeed, have so often been asked 
to admire the very evidences of disease — that we are obliged 
to disregard such general statements. 

While there is every reason to suppose that diphtheria 
is due to a special poison, it is also true (to quote from a well 
known authority) that "any abnormal state of the mucous 
membrane . . . affords an excellent abode for diphtheria." 
The home-treatment is suggested in what has already been 
said regarding hygiene. 



140 NURSERY PROBLEMS 



The Signs of Worms. 

My little girl, aged three years and five months, a sunny-haired, 
blue-eyed "bounie lassie," has been so robust most of her life as to 
make her German name, Gretchen, seem quite appropriate. She was 
taken sick about the 20th of May with severe vomiting and was very 
ill for days. I made up my mind afterward that it was the grippe. 
She had very high fever and coughed a long time after recovering 
otherwise. 

In July she seemed to have some intestinal catarrh. Though free 
from the diarrhcea now, she complains constantly at meal-time, and 
occasionally between times, of "stomach-ache." She has very dark 
circles under her eyes and is very unusually irritable. 

I am far from competent physicians, though the Japanese doctors 
about us frequently do us a good turn. 

Can I do anything special in the line of tonic treatment? Has 
she, perhaps, worms? After the sickness in May, which I called the 
grippe (the doctor called it whooping cough, but she never gave a 
suggestion of a whoop !), she passed one long worm. 

T shall be most grateful for any suggestions. 
Shonai, Yamagata Ken, Japan. G. 

To distinguish the ordinary intestinal catarrh from that 
which accompanies intestinal parasites, in default of the 
ocular demonstration of the worms, is practically impos- 
sible. Nor can one always say whether the worms are the 
cause of the catarrh, or the catarrhal condition renders the 
development of the parasite possible. This, too, even when 
the case is under observation, since the classical old wives' 
signs of worms are really but symptoms of gastro-intestinal 
irritation. It is, therefore, impracticable to say anything 
definite about a case at a distance. But the previous exist- 
ence of worms, as demonstrated, makes it rather probable 
that, similar symptoms continuing, others may be in the 
canal. It would be entirely proper to give a safe vermifuge 
— such as two grains of santonine night and morning for a 
couple of days, to be followed by a laxative. If you have 
no drugs at hand, you may find that common salt, a well- 



MINOR AILMENTS AND TROUBLES. 141 



known vermifuge in Oriental countries, will be sufficient in 
doses of 10 grains given three or four times a day. The doses 
may be given, if preferred, by rather over-salting the food. 
It has the advantage in these doses of being a tonic to the 
digestion. We may add that cod-liver oil, by its tonic 
effect, tends indirectly to destroy worms. 



Pin-Worms. 



Our baby is a year old, and has always been very well and strong. 
A few weeks ago, however, I found she was troubled with pin- worms. 
I used injections of aloes, and they soon disappeared, but after a few 
weeks returned, but under the same treatment she is free from them 
again. I would like to inquire the cause of these little pests, and if 
there is any way to get rid of them entirely. I had supposed worms 
were caused by improper food, but as Baby had never taken anything 
besides breast milk, that idea was discarded. 

Vincennes, Ind. K. 

The cause of pin-worms is always the introduction into 
the body of worms or their eggs. The worms may crawl 
from one child to another, while the eggs are obtained in 
various ways. They may cling to the finger nails of another 
child who has the worms and who has been scratching its 
seat ; they may be upon articles which the baby has access 
to, and so on indefinitely. Dogs often are sources of infec- 
tion, especially if they are allowed to lick a child's face or 
mouth. We cannot, of course, tell the source of infection 
in the case of your baby. 



'Worms.' 



I notice that you suggest worms as a possible cause of a child's 
restlessness at night. "Will you please tell something of this trouble, 
its symptoms, ami remedies? Is it very common, or is indigestion 
often wrongly failed "worms" '.' 
Galeaville, Wis. A. B. 



NURSER Y PROBL EMS. 



You are right ; indigestion is often mistaken for 
"worms," and that convenient word is made to cover a 
wide extent of ignorance. Intestinal worms, however, are 
not uncommon, and sometimes really are the cause of 
symptoms. The worm which most commonly disturbs sleep 
is the oxyuris vermicidaris, commonly called pin-worm, 
thread-worm, or seat-worm. By day these worms usually 
excite little disturbance, but at night, perhaps owing to the 
recumbency of the patient or the warmth of the bed, they 
create a severe itching and burning of the seat which may 
disturb or prevent sleep. In some excitable children 
marked nervous symptoms may ensue. 

The treatment consists of great personal tidiness and 
laxatives to carry off the worms. The itching is allayed by 
the removal of the worms from the seat, and this is usually 
most readily done by injections of soapsuds or of salt and 
water. Olive-oil injections are useful also. Unaffected chil- 
dren should not be allowed to sleep with affected ones, as 
the parasites may be communicated. 



Flatulence. 

My boy is ten weeks old, and ever since he was two weeks old I 
have nursed him four times a day and have fed him on Ridge's food 
three times a day — i.e., in twenty-four hours. He is troubled greatly 
with generated wind ou the stomach. Would you kindly explain 
what this is due to? Do you think it is the food, and would you 
suggest a change? The food seems to agree with him otherwise, for 
he weighs fifteen pounds, and feels well after nursing, although he 
feels uneasy and distressed after his bottle. 
Milwaukee, Wis. A Subscriber. 

As many infants entirely suckled are troubled with flat- 
ulence, we cannot certainly say that the food causes it in 
this instance. Nevertheless, we think that if the amount 
of flatulence was really troublesome we should try some- 
thing else. Wh3 T not good milk properly diluted ? 



MINOR AILMENTS AND TROUBLES. 143 

Night-Terror. 

My little boy is two years old r and all his life has been subject to 
violent passions of crying in the night, and instead of his growing out 
of them, although not so frequent, they are more violent. 

He goes to bed quite happy, but about 11 or 12 o'clock he begins 
to cry and moan, which gradually increases to screaming; he seems 
not to know me, and if I touch him, kicks and struggles. His eyes 
are open. I generally put my hand on him to hold him quiet and 
smooth his forehead with the other. Suddenly he is himself again, 
and asks to hold my hand or asks for a handkerchief to wipe his eyes, 
and after that I have no more fears of his crying again. He then lies 
awake for an hour or two, talking to himself, goiug through his little 
repertoire of words, until he falls asleep. 

He wakes next morning quite bright and evidently having for- 
gotten the commotion of the night, but he is heavy-eyed and rather 
irritable. As a rule he is an unusually merry, bright, intelligent 
child, with a wonderful memory. Has any mother had the same ex- 
perience ? It seems almost like hysterics. He has cut all his teeth ex- 
cepting the two large double ones. Can you suggest a cure? 
England. ■ A Worried Mother. 

The case is pretty clearly one of "night-terror," a dis- 
order of sleep peculiar to children. The trouble is akin to, 
but not the same, as ordinary nightmare. If there is no 
question of epilepsy — in this case there seems to be none — 
the usual result is recovery. These terrors occur in those 
children who are weakly, nervous, or anaemic, or who have 
rheumatic or gouty peculiarities by inheritance or otherwise. 
Besides, various irritations, such as teething, derangements 
of the digestive organs, including worms, and any kind of 
mental excitement or strain, are also considered causes, and 
probably the presence of imperfectly digested food in the 
alimentary canal ought to be placed at the head of these. 
Perhaps from these hints you can reach the cause in the 
case of your child. 



DEFECTS AND BLEMISHES. 



Umbilical Growth. 

I have a little nephew fifteen months old who has a navel rupture 
admitted to have been caused at the time of his birth. A small por- 
tion of what appears like proud-flesh protrudes slightly, and occa- 
sionally bleeds a little. It constantly exudes a watery matter, and 
must be kept covered with soft linen, which becomes thoroughly 
stained each day. The child seems to suffer no inconvenience from 
the rupture, running and jumping with unusual strength for his age ; 
we are not positive that there is tenderness under pressure. He is, 
however, troublesome to dress and care for, and there is alsoafear that 
the evil may increase, or that sometime a hemorrhage may ensue. A 
local physician has ordered applications of lunar caustic ; burnt alum 
and sugar, and other astringent remedies, have also been applied, with 
no effect. What is your advice as to treatment? 
Boston. A. E. W. 

The ailment is probably not a rupture, but the descrip- 
tion corresponds to a kind of fungous growth sometimes ob- 
served at the navel. If astringents fail, as they seem to 
have done in this ease, the application of the actual cautery 
(hot iron), which is not very painful, although appalling to 
the imagination, generally effects a cure. The treatment 
should be carried out by a competent surgeon, who could 
give an amesthetic if desirable. 



Round Shoulders. 

My little girl, four years of age, is forty inches tall and weighs 
thirty-three pounds — a gain of three-and a-half inches and four pounds 
for the last year. She has always been tall and slender, and from the 
time she began to walk we noticed a tendency to round shoulders — a 
tendency which has slowly developed until it is now quite marked. 
Her father's family, with the exception of her father himself and one 
brother, are all very markedly round-shouldered, one case of it in the 
family amounting to deformity. I have tried, long and patiently, 
speaking to the child and reminding her to hold herself straight, but 



DEFECTS AND BLEMISHES. 



she never remembers more than two seconds at a time, and my efforts 
result in flat failure. I wish to know if I should put braces on her 
this fall, and, if not, should I do so at a later time? 

She has always been delicate until the last six or eight months. 
Though not what one could call a very robust child, she seems per- 
fectly well, has a fair appetite for plain, wholesome food and an ex- 
cellent digestion, is regular in her habits, and sleeps soundly and well 
from ten to eleven-and-oue-half hours out of the twenty-four. 
St. Louis. L. H. H. 

First make sure that near-sight has nothing to do with 
the tendency to stoop, although in so young a child it is not 
so likely to be the cause as in one who has begun to use 
books. Speaking to a child rarely, if ever, does any good in 
this complaint. The stoop is not the result of desire or of 
indolence ; it is usually due to some feebleness of the muscles 
of the back, which may indeed be hereditary, as you seem to 
suppose it to be in this case. The cure is general strengthen- 
ing of the child and gymnastic exercise of the muscles of the 
back and shoulders, which she can get at a calisthenic class. 
If there is any spinal trouble a support suitable to the par- 
ticular case should be prepared or selected by the surgeon 
who has charge of the case. The use of braces depends 
upon the degree of stoop in the shoulders ; if it is great, or 
if the exercises do not diminish it, the braces are worth try- 
ing. For directions as to the kind needed you should con- 
sult one of the best surgeons in your city. 



Fear of Bow-Legs. 

Our baby is a bouncing big one, weighing about twenty-eight 
pounds at a year old. The subject of bow-legs is a serious one with 
us, and we do not allow him to follow his inclination to walk in con- 
sequence. Some say that lime-water will prevent it, and the ounce of 
prevention is what we want. What do you advise? 

C. G. N. 



146 NURSERY PROBLEMS. 

You do not say why bow-legs are anticipated by you. 
The commonest cause of bow-legs is rickets — a disease which 
is characterized, in its full expression, by deformities of the 
bone, due to deficiency of phosphate of lime in the bones as 
well as overgrowth of the organic parts. The lime-water 
has been used very much as a remedy for rickets, and so in- 
directly to prevent bow-legs. It is not a preventive of bow- 
legs except when rickets exists. But rickets, being a disease 
of nutrition, it is best met and prevented by careful watch- 
ing in this direction, and if any evidences of the early 
stages of the malady exist they should be attended to 
promptly and the disease arrested. A child should be al- 
lowed, as a rule, to follow its own impulse about getting 
upon its feet. It should not be placed on its feet except, 
perhaps, when struggling to get there of itself. But when 
a child is able to get up alone it is very difficult to hinder it, 
and there is rarely any reason for doing so. 



A Confirmed Habit of Stumbling. 

Is there any remedy but "moral suasion "for a confirmed habit of 
stumbling on the part of an active boy between five and six years old? 
There is no evidence of weakness in his legs or ankles, yet it is a very 
usual thing for him to fall at the slightest obstacle, like a projecting 
paving-stone or any other unevenness in the street, or even in the 
house, like a door-sill. Severe bruises and bumps appear to convey 
no lesson, and as it seems to be only a habit of extreme carelessness we 
appeal to you to suggest the best punishment. The matter is rendered 
very serious to-day by a fall, while running, in which our boy struck 
his forehead on a sharp stone, making two or three mutilations which 
will probably leave permanent scars, to say nothing of the present 
pain, which will keep him housed for nursing for some days. We 
tremble to think of what the consequence would have been had the 
stone struck his eye instead. 
Stapleton, N. Y. D. 



DEFECTS AND BLEMISHES. 147 

Differences in natural agility are very great. Further, 
clumsiness is often increased by certain illnesses. For in- 
stance, some diseases, like scarlatina and diphtheria, which 
have often paralytic sequels, sometimes are followed by a 
certain clumsiness of gait, which depends upon no recog- 
nizable paralytic condition. We can recall children whose 
gait after such diseases was strong and enduring, but whose 
feet fell like hammers. Again, some ailments cause a dimin- 
ution of that harmony of movement called co-ordination; this 
is one of the results of phimosis. The harmfulness of 
phimosis has been much exaggerated ; nevertheless, in every 
case of excessive clumsiness in a boy this possible cause 
should be inquired into. In any case, we should not think 
of punishment to cure stumbling. If judicious coaxing and 
"slowing down" will not break the habit, punishment will 
not, but will rather render the child more self-conscious, 
and therefore more clumsy. 



A Tongue-Tied Baby. 

What shall be done for the baby that is tongue-tied? Shall the 
string be cut? 

Townsend, Mass. N. 

"Tongue-tied" means that the natural bridle under the 
tongue is so much shorter than usual as to inconvenience 
the child in some way. It is rarely as much of a hindrance 
to speech as is supposed, because if the child's tongue is free 
enough for it to suck well, it is free enough for speaking. 
Occasionally, but rarely, a child is born with so short a 
tongue-bridle as to prevent nursing, and in such cases cut- 
ting of the bridle is demanded. In other cases it is not 
really called for, although sometimes done in obedience to a 
popular belief. The cutting is a trivial matter, if done by a 
competent person. 



NURSERY PROBLEMS. 



"Whopper-Jaw." 

My baby is now over ten months old. She has cut the upper and 
lower central incisors, and is now getting the lateral incisors. The un- 
der teeth shut over the upper ones. Is there any danger of her being 
"whopper-jawed " when she has all her teeth ? If so, can. anything 
be done to prevent it? Her mouth when closed appears perfect, 
though the teeth are as I have described. 

Nahant, Mass. M - B - H> 

The projection of the under-jaw, rather than the teeth 
themselves, usually causes the condition of " whopper-jaw," 
and it is doubtful whether it can be artificially modified. If 
the condition continues aud appears dependent upon the 
teeth, your dentist can tell you if their position can be 
rectified. 

Deaf- Mutism. 

What would you think of a child, nearly three years old, who did 
not say a single word ? I do not mean one who has a language of his 
own, unintelligible to others, the simple fact being that he does not at- 
tempt to utter a word, and it is very hard to see that he comprehends 
when spoken to. I have in mind a little fellow who is causing us 
much anxiety on account of his backwardness about talking, or rather 
of his not speaking. What would ysu advise? 

New York. A Grandmother. 

Such a child should be first of all examined for deaf- 
mutism, and, if it hears well, some one familiar with such 
matters should inquire into its intelligence. In order to as- 
certain whether the child hears, the aurist relies upon the 
tuning-fork, whistle, and bell, or instruments producing 
noises of a similar character. In applying any of these tests 
it is necessary to be on one's guard and exclude the possi- 
bility of the child having its attention called to the various 
testing-objects by senses other than that of hearing. For 
instance, the mother may test with a whistle ; the child 
turns at once and she reasons that it has heard the sound. 
This, however, may not have been the case ; the blast of air 



DEFECTS AND BLEMISHES. 149 

leaving the whistle may have impinged upon the child's 
face, and this may have caused it to turn around. In like 
manner, a child may turn because it feels the vibrations 
transmitted by the floor, following the violent closure of a 
door ; yet this action on the part of the child may be wrong- 
fully attributed to its having heard the noise. 

An important peculiarity of deaf-mutes, though not in 
itself an absolute proof, is their manner of expressing their 
desires through gestures, and their impatience and anger 
when not understood at once. One of the most important 
signs, of course, is the fact that the child does not begin to 
talk when it should. No mother should accept the verdict 
of deaf-mutism until such an opinion has been given by a 
competent aurist after he has examined the child's ears. A 
child may, as a result of being born so, or as the consequence 
of disease of the ear after birth, whether this has been 
noticed or not, be very hard of hearing and yet not be abso- 
lutely deaf. If nothing be done for such a child, its deaf- 
ness iiecomes worse from disuse of the organ of hearing, 
and finally may become absolute ; whilst if proper training 
and treatment had been instituted in such a case, some amel- 
ioration of the defect may have been achieved. 

Freckles. 

You will perhaps be inclined to smile at the vanity of a mother 
who asks for a remedy against freckles ; but the affair is not so unim- 
portant as it may seem to many. If we are at all justified in trying to 
improve our personal appearance, why should it be wrong or trivial to 
struggle against freckles, which darken and disfigure so many other- 
wise bright faces ? . If they would confine themselves to boys perhaps 
they might be tolerated, but in the case of my own children, at least, 
they attack both sexes with equal impartiality, not sparing even my 
little girl baby of fourteen months. If still possible, I should like to 
save her from the fate of her brothers and sisters. Is there a remedy '.' 
< >f course, I know it would be wrong to try to remove freckles by any- 



-V URSER Y PR OBL EMS. 



thing that might injure the skin ; but is there nothing harmless that 

could lie used to advantage ? Is it advisable to avoid exposure to the 

sun ? Will broad-brimmed hats be of any use in keeping the fiend off? 

Kansas City. Mo. G. S. 



Freckles are annoying, and are often apparently very 
disturbing to those who set much store by their complexion. 
These peculiar pigment deposits are usually confined to the 
parts of the person which are exposed to the light — the face 
and hands, namely — and are therefore not easily concealed. 
Although it is true that they sometimes appear upon the 
clothed parts of the body, yet there is very good reason to 
believe that exposure to light is then essential cause. They 
appear in summer, when the hours of light are long and 
outdoor life most indulged in. Furthermore, freckles are 
peculiar to certain complexions. Brunettes rarely, if ever, 
freckle ; they become tanned. Blondes of the florid type— 
those with red or reddish hair — are much more susceptible 
to freckles than others. With the passing of summer the 
freckles fade or disappear, and in winter are scarcely notice- 
able, and as adult life is reached they are less evident and 
abundant, independent^' of the care then bestowed upon 
the complexion. 

The causes being thus a peculiarity of complexion and 
exposure to light, it is impossible to do much for them with- 
out doing harm to the general health. Some local applica- 
tions will temporarily make the freckles paler, but the only 
real treatment is prevention by exclusion of light. This, of 
course, will be presently destructive of the health of the 
child. It is possible to lessen the freckling, however, by 
avoiding exposure to the strongest glare of the sun, and the 
shade-hats are of some value in this direction. 



DEFECTS AND BLEMISHES. 



A Blemish on Baby's Face. 

Our baby is now more than three months old. Two or three weeks 
after her birth a red mark appeared on her nose. We thought at first 
that she had scratched herself pretty vigorously, but on consulting a 
physician a few weeks later he pronounced it a " mother's mark," and 
advised the use of electricity for its removal ; this has been applied three 
times, and the redness has gone from the mid He of the mark. Would 
you advise us to continue the use of the electricity, or could we do 
better? We dread to have it used, for it frightens the little one very 
much, and must be painful. Is it likely that the mark would disappear 
of itself after a while? 

I have heard of saliva being used with success to remove marks, 
and also that the juice of the milkweed plant is good. Is it probable 
that either of these would accomplish a cure ? 

Morristown, N. J. A. E. P. 

There are "mothers' marks" of various kinds and of 
many degrees of severity. Some of the very faintest ones 
we have seen fade partly or wholly without treatment, but 
as a rule they do not. As a mark upon the face of a woman 
is a mutter of great conceru to her, every endeavor should be 
made to get rid of one, if it be of any importance, before 
the age of self-consciousness. 

The saliva is valueless for the real "mothers' marks," 
and so, too, is the milkweed-juice. Whatever value the lat- 
ter has is in cases of the most superficial kind. In this case 
the continued use of the electricity seems to be advisable. 



Warts. 

Will you tell what one may do to remove warts? My Paul, five 

years old, has nine on one hand. I overheard his brother telling him 

he did not love him so well since he had those dreadful things on his 

hand. What does cause them ? and what will prevent their coming? 

Pennsylvania. B. 



N URS Eli Y PROBL EMS. 



Warts consist chiefly of an overgrowth of the papillae of 
the skin. The exciting causes of this overgrowth are various, 
and often no cause is recognized. They are more likely to 
occur in childhood, probably because all the phenomena of 
growth are then more active than at other times. They 
seem to be most common where the skin is most exposed to 
all kinds of irritation, as upon the hands. Sometimes they 
appear to be communicated from one person to another, and 
some persons show a great susceptibility to them. 

Warts usually appear suddenly, and often as suddenly 
disappear. Doubtless upon this peculiarity depends the ap- 
parent success of the charms and incantations so commonly 
employed for their removal. It is possible that in some in- 
stances where the charm involved the rubbing upon the 
warts of the juice of certain leaves the latter may have 
really had a medicinal influence. 

The most prompt and efficient method of disposing of 
warts is to thoroughly scrape them out. This leaves a little 
" punched-out " looking hole in the skin, which heals 
quickly if kept clean. If any bleeding occurs it can be 
stopped by hot water. This extirpation, if thorough, gen- 
erally prevents a return. 

If this seems too radical a performance for domestic 
medicine, the glacial acetic acid or a saturated solution of 
salicylic acid may be applied carefully to the wart. The 
stick of a match or a piece of cigar-lighter is a convenient 
implement for making the application. ■ The liquid should 
be applied freely to the wart, but not allowed to flow around. 
The surrounding skin may be protected by vaseline or bi- 
carbonate of soda before the application. After a day or two 
rub off the dead part and make a new application, and re- 
peat until the wart is gone. 



DEFECTS AXD BLEMISHES. 153 



Ringworm. 

My little boy, four years old, has a "ringworm" on his forehead 
about one inch and a half in diameter. I have used a preparation of 
potash, and it seemed to stop it for a while. I am now painting it 
with iodine, but it does not seem to do much good. Can you tell me 
what causes it, and how I can cure it? It cannot be hereditary, for I 
am perfectly healthy, and have never had anything like that, nor has 
his father. 
New York City. C. H. 

Ringworm is not hereditary. It is due to a vegetable 
parasite which grows upon the skin. The cure consists in 
allaying inflammation and killing the parasite to the last 
spore. The tincture of iodiue is usually successful if per- 
sisted in. It must be painted over all the changed parts of 
the skin. Daily frictions with green soap — a kind of soap 
much used for skin diseases — are useful, and any germicide 
not too strong will help. One of the safest for domestic use 
is the hyposulphite of sodium. Dissolved in five parts of 
water, it may be applied locally. On the face care should 
be taken not to use too strong applications, as slight scars 
may be caused. 



The Removal of a Birth- Mark. 

I wish to consult you about my little five-weeks-old babe, who has 
been unfortunate enough to be birth-marked on the face. Both eye- 
lids have reddish veins over them, the left much worse than the right. 
Half of the lid looks red, and there is a spot of a darker hue on the 
right nostril. When the child is passive the spots are dim, but when 
active they become brighter. They are not yet blood red, though I fear 
they will become so. As the complexion clears they become more 
prominent. I would like to ask : 

(1) If there is any probability of their dying out without treat- 
ment ? 

('_') Arc there instances where such spots have been entirely oblit- 
erated '.' 



154 NURSERY PROBLEMS. 



(3) If electrical treatment is used will it endanger the sight? 

(4) What kind of electricity is needed — galvanism, or would a 
Faradic battery do ? 

(5) At what age would it be best to commence ? 

(6) Is there any other treatment that could be tried ? 
Yokohama, Japan. W. 

(1 and 2) There is little probability of their spontaneous 
disappearance. 

(3 and 4) Not if properly applied. The form of elec- 
tricity used in such cases is what is called electrolysis, a 
needle connected with the battery being thrust into the part 
to be destroyed. It may leave a scar. Neither galvanism 
nor Faradism as ordinarily applied is of value. 

(5) As soon as the proper surgical attention can be 
secured. 

(6) Yes ; hot needles, caustics of various sorts, etc. Vac- 
cination, sometimes employed, is not suitable, owing to the 
situation of the mark. 



THE TEETH. 



Care of the Teeth. 

"What food is the best for strengthening the teeth ? 
Butte, Montana. G. 

If there is no evident disease of the teeth, the best way 
to insure continued soundness is not to give any one thing 
supposed to be strengthening to the teeth, but a good, 
wholesome diet, and, above all, to avoid the use of those 
things known to damage the teeth. The articles of food 
most likely to injure teeth are probably those the digestion 
of which, either generally or in the particular instance of 
the person concerned, are found to promote acidity of the 
stomach. Of course careful attention to the toilet of the 
mouth is assumed and the care of a dentist whenever his 
services may be needed. Actual disease of the teeth can 
rarely be controlled without his attention. We may add 
a word concerning the teeth of young children. It is of ad- 
vantage to keep an infant's teeth clean in the same way as 
an adult's teeth are so kept. If teeth are already decayed 
they should be carefully attended to, and the decay hindered 
by cleanliness after each meal. If teeth are defective in 
structure, with, for instance, thin or irregularly absent 
("worm-eaten ") enamel, it is doubtful if anything can be 
done to strengthen these particular teeth, but coming teeth 
may be helped by care of the general health, and, as many 
believe, by the use of the lime salts, particularly the phos- 
phate. The hypophosphite, generally found in the drug-shops 
in the form of a syrup, seems to be of some use. The same 
may be said of the syrup of the laeto-phosphate of lime, and 
some judicious practitioners still esteem the powder of phos- 
phate of lime, and even the powder of ground bone. 



N I 'USER Y PR OBLEMS. 



Effect of Feeding upon the Teeth; the Use of 
-the Tooth-Brush. 

(1) I have heard as coming from a physician that feeding a baby 
very early, before the nursing period was ended, had a tendency to in- 
jure the material of thecoming teeth. What can you tell me about it? 

(2) Should a child's first teeth, as soon as they are well matured, 
be brushed with a tooth-brush or simply washed as the mouth has been 
washed before? 

Canton, N. Y. R. 

(1) Any improper feeding before or after the discontin- 
uance of nursing, or even nursing when the milk is im- 
poverished, may lead to rickets and to imperfect teeth as a 
result. The question is as to the kind of food rather than 
the mere fact of feeding. 

(2) The tooth-brush will not harm the teeth directly, 
but it may, especially if stiff, injure the gums and second- 
arily the teeth. Little children, and especially babies, do not 
usually like to have their teeth brushed, and struggle against 
the performance. It is, therefore, difficult to apply the brush 
as accurately as could be desired. Consequently, to avoid 
the injury to the gums spoken of we think the washing 
preferable. 



Decaying Teeth. 
I. 

My baby, a year old, has twelve teeth, but they are all decaying. 
(1) "What am I to expect in relation to the second set? 
Elmira, X. Y. M. T. C. 

II. 
My baby-boy, seventeen months old, has fourteen teeth. The first 
ones already show signs of decay. (2) What is the cause of this, and 
can it be arrested ? (3) If so, how? (4) Which are the "stomach- 
teeth"? 

CavfiehL Ohio. F. M. S. 



THE TEETH. 



(1) Unfortunately this trouble is only too common. The 
condition of the second set will depend upon the health of 
the child iu the years preceding the appearance of that set, 
and upon the care you bestow upon the first set. 

(2) There are several causes known, besides some which 
are only partly known. By all odds the commonest cause is 
faulty nutrition, which may exist whether the child is 
nursed or fed. 

(3) If the defects are localized, your dentist can do much 
to preserve the teeth by careful attention. If the decay is 
general, involving the whole surface of the teeth, he can do 
less or little. But he should by all means be consulted and 
allowed to judge whether or not the case is one which he 
can benefit. The expense will be well repaid by the im- 
provement in the child's freedom from toothache and in the 
better condition of the coming set. 

(4) The "stomach-teeth" are the canine or "eye" teeth 
of the lower jaw. The canines are called "eye" teeth be- 
cause of their position under the eye. Those of the lower 
jaw are called "stomach-teeth" from a tradition or supersti- 
tion that their eruption is attended by unusual stomach dis- 
order. 

Discoloration of the Teeth. 

My baby is two years and a quarter old. He has been very 
slow cutting his teeth, the last ones (his stomach-teeth) having come 
through two weeks ago. About two months ago I noticed his four 
front upper teeth were turning dark ; the discoloring now covers more 
than half the upper part of them. He has always, though very good 
about everything else, fought against taking a drink of water and 
having his mouth washed, consequently it has been very imperfectly 
done. Could that cause the trouble, or does it come from acidity of the 
stomach, from which he suffered greatly the first year? We tried 
changing his food, but found he retained the " Eagle Brand " of con- 
densed milk best. 

German town, Pa. L. C. W. 



NURSERY PROBLEMS. 



If the discoloration is only a superficial one — that is, 
simply the greenish stain often seen on the teeth— it is prob- 
ably due to the neglect of cleansing. The fact that the dis- 
coloration is on the upper half of the teeth makes this more 
likely. But we ought to say that the same physical pecu- 
liarity that favors late teething also is attended with 
stomachic disorders and discoloration and early decay of the 
teeth ; so this is a matter to be looked into. The damage to 
the teeth does not come immediately from the acidity of the 
stomach, but thev are associated manifestations of one cause. 



Peculiarity of Teeth. 

My baby, nearly two years old, is perfectly well. Her little 
tongue is as red and smooth as possible, but she has several small 
spots, depressions, somewhat discolored, on the face of the front upper 
two teeth. This peculiarity exists in her father's family, the front 
teeth of several of the members being short, strong, and healthy, but 
not perfectly white, and having these discolored depressions, about the 
size of a small pin-head. Can anything be done to prevent the second 
set from appearing the same way ? She has had eighteen teeth for six 
or eight months past. 

St. John, X. B. B. B. H. 

This peculiarity of the teeth is well known. We recall 
families where it is found in parents and children, having 
existed from childhood in the parent. Now, whether the 
peculiarity is a hereditary one in the strict sense, or whether 
some nutritional peculiarity that has caused it in two gen- 
erations is the heredity, or whether it is simply due to some 
traditional (and in one sense hereditary) method of feeding, 
we cannot determine. We incline to the second supposi- 
tion. The fact of their existence in the primary teeth does 
not determine their reappearance in the second set. We 
know of nothing except general good hygiene that will do 
any good. Keep the child as well as possible, and wait. 



THE TEETH. 159 



The Effects of Whooping-Cough on the Teeth. 

When my little girl was six months old she took whooping 
cough, and suffered with it for the next four months. It was a long, 
hard siege for us, but, as she seemed to recover entirely from it after 
that time, I congratulated myself upon having one complaint of child- 
hood out of the way. But when the permanent teeth began to come 
through, the lower incisors had a ridge across them about half-way be- 
tween the crown of the tooth and the gum, and the upper incisors a 
row of tiny holes in the enamel about the same distance from the 
crown. The first double-teeth, those next to the wisdom-teeth, had no 
enamel on the top, and it soon became necessary to cap them with gold 
— a painful and expensive operation. As soon as the dentist looked 
at her teeth he asked if she had had any sickness in infancy. 
"Only the whooping-cough," I replied. "That is the mischief- 
maker," he exclaimed, and then told me that whooping-cough, scarlet 
fever, and measles in infancy affected the permanent teeth in propor- 
tion to the development of each tooth in the sac. We hope the other 
teeth may have escaped the ill-effects of this simple disease, as they 
probably were not sufficiently developed to be caught by it. I have 
only my dentist's word for it, and my knowledge that the child was a 
very healthy child and gave no evidence of defective nutrition that 
might cause unsound teeth, and she does not inherit such teeth. I 
should very much like to know if in your opinion the dentist's diagno- 
sis was correct. 

Honolulu, Sandwich Islands. E. A. C. 

It is a common belief among dentists — and doubtless a 
correct one — that infantile disorders affect tbe development 
of both sets of teeth How far one can correctly specify 
which particular disorder caused this damage we are in 
doubt about. There is nothing improbable in the opinion 
that acute diseases like whooping-cough may affect the 
teeth. On the other hand, rickets, the disease of all others 
to affect teeth, is usually overlooked by mothers and by 
many physicians ; and so a mother might with perfect 
honesty say tbe child had had no disease, when it had had 
just the disease to destroy its teeth. There comes to mind 
at this moment the case of a lad whose mother told ns the 



NURSERY PROBLEMS. 



same story of some disease in infancy having destroyed his 
teeth, but neither she nor the family physician seemed to 
have recognized the rickets, which had left various traces 
behind besides the defective teeth. 



Loss of a First Front Tooth. 

Last February my little girl, then just two years old, was so un- 
fortunate as to lose her footing while trying to step on a bucket in our 
pantry, and her mouth struck against its sharp edge so violently that 
an upper front tooth was knocked out. The little one did not seem to 
sutler with the hurt after three minutes, and, excepting a badly swollen 
lip and tenderness of the gum that day, has suffered no inconvenience. 

I fear the remaining tooth is slanting a little into the cavity made 
by the lost tooth, and more than filling its share of space. When 
Baby's second set of front teeth grow, can I expect them to be even, 
and of the same size ? Her front milk-teeth had these characteristics 
before the hurt. Ought I to have the odd tooth extracted before the 
second teeth appear? Could the little one have sucked the tooth back 
into its socket immediately after theaccident as we have known adults 
to have done? 

Madison, Me. C. P. 

It is not probable that the undeveloped tooth of the per- 
manent set was injured by the accident, and it is reasonable 
to expect that when it comes it will be of proper size. Even- 
ness depends partly upon the space at the time it comes, but 
if the teeth push through in an irregular manner they pretty 
certainly can be straightened by any dentist. Leave the odd 
tooth if sound. 

Teeth are sometimes replaced after having been knocked 
out, aud are firmly held so as to be useful. As a rule, we 
think the experiment worth trying. 



THE TEETH. 



Removing Redundant or "Extra" Teeth. 

My little daughter, twenty-three months old, has a redundant in- 
cisor tooth which came through three months ago, forcing its way 
painfully between the two upper incisors on the left side of her face. 
The back one of these incisors pierced the gum a little higher up and 
further back than the corresponding tooth on the right side, thus leav- 
ing a space between the left incisors about half the width of a tooth. The 
redundant incisor cut through this space obliquely, with the edge of the 
tooth directed to the left and outward instead of downward. It is dis- 
figuring, and will, I fear, crowd the other teeth, and I do not wish it 
to appear in the permanent set. Will you kindly advise me how soon 
it should be extracted, also if the operation will be attended with any 
danger? I have feared the effects of an anesthetic on so young a child, 
especially as she is of a very nervous organization. 

Korth Ontario, Cal. J. 

Such a tooth is usually removed by deutists as soon as it 
crowds the others, or wheu they thiuk the proper order of 
the teeth is deranged by its presence. Whether or not a 
supernumerary tooth will appear in the permanent set does 
not depend upon the extraction of the present tooth, but 
upon the existence or absence of the rudiment of that per- 
manent tooth in the jaw. A dentist of ordinary skill can 
extract the tooth safely and will advise you if he needs ad- 
ditional aid in giving the anaesthetic, if indeed that is nec- 
essary. The simple extraction of an incisor might cause less 
disturbance than the administration of an anaesthetic. If a 
supernumerary tooth appears in the second set the dentist 
can also advise concerning its removal. 



THE EYES. 



Test for Cross-Eyes. 

Yesterday morning my nest-door neighbor, a mother of two chil- 
dren, sent to know if I would run in there a minute in haste. On 
going into her sitting-room I found her quite agitated —unduly so, it 
seemed to me, when I learned the cause. She said : "I'm going to 
ask you a question which I wish you'd answer as quickly as you can, 
without giving yourself time to think out anything more than your 
first impressions. Willie, stand right there and look straight for- 
ward at Mrs. B's face. There, now, Mrs. B., is he cross-eyed? " She 
went on to say after a short pause that she had been startled to find 
him, as she thought, cross-eyed in the morning, and yet she could not 
satisfy herself of it. I confess it was difficult for me to decide ; there 
were moments when he seemed decidedly so, and again I could hardly 
distinguish it. To-day it is certainly more marked. I told her there 
was only one thing to do, and that was to consult some authority. 
Are there not certain simple tests used by oculists which we can apply 
at home ? If you can give us any help you will greatly oblige both 
of us. Willie is five years old, and almost as great a favorite in my 
home as in his own. 

Banbury, Conn. J. M. B. 

The test most commonly employed by oculists to detect 
"cross-eyes" or "squint" is to cover one eye, and have the 
child look with the other at the examiner's finger, held at a 
distance of about fifteen inches directly in front of the child 
in the median line ; if this be done, and the hand covering 
the eye be slightly tilted so that the examiner can watch the 
covered eye, the latter will be seen to roll, or move inward 
or outward, according to the nature of the squint. Then, by 
suddenly removing the hand from the eye previously cov- 
ered, the difference in the direction of the axes of the two 
eyes will be very apparent ; the observation must be made 
quickly, however, since the squinting eye will soon correct 



THE EYES. 163 



its position so that its axis will correspond to that of the 
other eye, and both will then become fixed upon the ex- 
aminer's finger. This test should be applied first upon the 
eye which appears to squint, and then upon the other in a 
like manner. 

It must be remembered that cross-eye, at the commence- 
ment of the trouble, is often present only at certain periods 
and absent at others. Also, that it is frequently due to 
errors of vision, which sometimes may be corrected by the 
fitting of proper glasses. 

Anxiety about Brilliant Eyes. 

Is there any necessity for worry because a baby has bright eyes ? 
This seems like a very silly question, but I suffered with a complica- 
tion of nervous troubles before my baby was born, and have been es- 
pecially sensitive about him. And now an officious friend has 
"stirred me up " ; on first seeing my beautiful, healthy boy, he ex- 
claimed, " What wonderfully bright eyes he has! Has he ever had 
anything the matter with his head ? No ? I thought he might have 
had, as they are so very bright ! " Under the circumstances I did not 
like it, to say the very least. No one else thinks his eyes are so 
■wonderfully bright. 

Cranford. N. J. M. C. H. 

There is no necessity for worry whatever. Nor, as far 
as you have given the facts, is there any ground for anxiety. 
If you have reason to suppose your baby hereditarily ex- 
citable, try to avoid excitements for him. Brilliancy of the 
eye is not an evidence of disease by itself. 



Eye-Pupils of Different Sizes. 

How serious a trouble is a difference in size of the pupils of the 
eyes, or how serious may it become? What may be done to correct it 
or its cause? My boy is six months old, and the difference in his 
pupils is very marked at times. When the pupils are small I observe 
no difference, and for a time have thought the direction or amount of 
light had the effect named ; but now I am convinced the pupils are at 
fault. 
Georgetown, Col. A. E. P. 



164 NURSERY PROBLEMS. 



The difference may or may not be a symptom of impor- 
tance. Associated with other disturbances it often betokens 
serious brain troubles. On the other hand, cases are met 
with — we have one under observation just now — where the 
discrepancy has existed from birth, and has continued many 
years in a person of good health, who is unconscious of any 
disturbance of vision. 



Styes. 

Our little girl is fourteen months old, and has always been quite 
well. I weaned her at eleven months, and she has since lived on 
bread, milk and gruel of Quaker oats. Lately I have cooked the oats 
longer and fed them to her without straining. 

She has had twelve styes or little boils on her eyelids. They com- 
menced to come about six months ago, a little before I weaned her, 
and just after the first teeth had come through ; she now has eight 
teeth. During the last few months she has grown thin, but of late 
seems to be "picking up " again. She has also been constipated at 
times and often has a foul breath. All but two of the styes came on 
the tips of her lids, both upper and lower, and they have caused her to 
lose nearly all of her eyelashes. The last two styes seemed more 
serious than the others. One was almost on the side of her nose and 
was opened four times, twice by myself and twice as she hit it with her 
hand, each time discharging much matter. I have consulted three 
physicians but they have not helped her. 

(1) Can you tell me the cause ? 

(2) How can I help her ? 

Denver. M. A. 

(1) The ordinary causes are local inflammatory irrita- 
tion, acting upon a system deranged in some way, especially 
when the patient suffers from anaemia (thinness of blood), 
or is of scrofulous habit. 

(2) The general condition must be looked to. The diet 
should be examined to ascertain if it be well digested. Iron 
may be needed or perhaps cod-liver oil. Locally the prompt 



THE EYES. 165 



opening of styes as they occur is very useful. Some of the 
products of the inflammation may not be discharged as pus 
and later on may excite further irritation or remain as an in- 
dolent mass in the lids. These are the general principles of 
treatment. Although you have consulted three physicians, 
we still think that you will do better to try again than to at- 
tempt domestic treatment. Pick out one physician and 
continue with him long enough to find out what he can do 
and to give him some interest in his little patient. 



Clipping the Eyelashes. 

Is it true that clipping the ends of the eyelashes is beneficial, and 
is it likely to cause them to grow longer ? When is the proper time to 
do it? 
Santa Barbara, Vol. "Gwaery." 

Clipping the eyelashes cannot be beneficial in any way, 
but may be decidedly harmful. The lash is the protector of 
the eye. Cutting, if it affected them at all, would be likely 
to make them coarse. There is no proper time to do it. 



THE EARS. 



Earache. 

Can you give any suggestions as to remedies for earache in chil- 
dren ? My little boy of five suffers from it very much, and it always 
comes on at night. I use sweet oil and laudanum, warm, dropped in 
the ear, or soak a piece of cotton, and put it in the ear ; to this I some- 
times have to add a hot poultice of hops, and all this will frequently 
give no relief for a long time. There does not seem to be any especial 
cause for these attacks, as our physician has examined him several 
times. 

Brooklyn, N. Y. A. S. 

The occurrence of pain in the ear is a pretty positive 
sign that this organ is not in a perfect condition, or that 
some part in the immediate neighborhood is diseased ; thus, 
besides disease of the ear itself, ,such pain may be due to the 
impaction of wax in the ear canal, or to throat or nose 
trouble. Hence removal of the cause of the pain by the 
specialist would naturally be most advisable. To relieve the 
attacks of earache, when the cause is unknown, the instilla- 
tion of hot salt water will be found most efficient. The salt 
water should be prepared by dissolving a teaspoonful of table 
salt in one pint of water. This should be used as hot as can 
be borne by the sufferer, and should be poured into the canal 
of the ear by a teaspoon and then allowed to run out again 
by inclining the head ; this may be continued for half an 
hour or an hour until the pain ceases ; or the hot salt water 
may be allowed to flow into the ear from a fountain syringe 
held not higher than one foot above the level of the ear. 
After the application of heat in this way, a large piece of 
cotton wadding should be placed over the ear and covered 
by a layer of oiled silk. 



THE EARS. 



Internal Ear Disease. 

My little son was apparently a perfectly healthy and normal 
child in every way at birth. A plentiful supply of breast milk 
awaited him and his digestion was perfect. He grew at the rate 
of almost one pound per week from birth. When four weeks old I 
noticed, after his first night of unrest and crying spells, a dis- 
charge from one ear of a thin watery substance, such as usually comes 
from a gathering in the ear. When it had continued, though in very 
small quantities, for two or three days, I spoke to the physician about 
it, and he advised washing out the ear, which he accordingly did, 
using a very fine ear syringe. The child apparently suffered no dis- 
comfort during the operation, not even moving his head. Three days 
after that (the discharge not having appeared at all after the washing), 
when I placed my hand under the child's head for the purpose of 
placing him in the bath, he gave a sharp scream as though in great 
pain. I examined his head, but saw nothing unusual externally. 
During that day and night his head was somewhat hot and he slept 
constantly, scarcely rousing to nurse, although I put him to the breast 
at regular intervals, and making a sharp scream when touched or 
lifted. The following morning I sent forthe physician, who, on seeing 
the child, pronounced the trouble probably an internal abscess of the 
ear, and gave me small hope of his surviving. An ear specialist was 
immediately sent for, who punctured the ear-drum in the hope of 
allowing any matter which might be pressing on the brain to escape. 
Nothing availed, however, and after twenty-four hours of extreme 
suffering, during the last eight of which the child was in frequent 
spasms, he passed away in one. I should, perhaps, say that crossing 
the eyes was one of the first unusual signs of trouble which I noticed. 

I should like to ask : 

(1) Should you judge from the symptoms that the ear was the 
seat of the trouble? 

(2) Could such trouble be produced by the washing out of the ear 
and stopping of the discharge? If not caused from the ear, could any 
other likely reason for such an affection be suggested ? 

(3) Was it probable that the child was born with any tendency to 
brain disease, and if so would it not have shown itself sooner .' 

(4) Could anything have been done which was not done, or in 
addition to what was done ? Beyond the puncturing of the ear-drum 
and the application of cold cloths to the head, nothing was done in the 



Xl'RSKR Y PR OBL EMS 



way of treatment. I take the liberty of writing somewhat at length, 
as the physicians to whom I have spoken pronounce it a most unusual 
and extraordinary case, and also because we do not feel at all sure that 
it was not the result of carelessness in some way. 

P. F. C. 

(1) The ease was probably one of disease of the deeper 
portion of the hearing apparatus, the internal ear; as a result 
of this the adjacent portions of the membranes covering the 
brain were probably involved. 

(2) Washing out the canal of the ear could not have 
produced the trouble ; the affection had already existed 
when the ear was syringed, and this proceeding merely 
cleansed the canal, and in this way was beneficial. 

(3) It cannot be stated definitely with the material of 
your letter as a basis, whether there was any tendency to 
brain trouble at birth ; there may or may not have been ; 
such deep troubles in the internal ear may develop in infants 
who have previously been in perfect health. 

(4) The treatment adopted was proper and all that is 
usually made use of in such cases and at this period of 
life. An operation — making an opening through the bone 
behind the ear, so as to reach the deeper parts of the ear and 
allow any matter that may have gathered there to escape — 
sometimes saves life in such cases; but this operation is itself 
a grave one and its results are uncertain ; in the case in ques- 
tion, owing to the very early age of the patient and the rapid 
course of the disease, even such a last resort would probably 
not have prevented the fatal termination. 



Partial Deafness. 

I wish to get advice through your columns in regard to my little 
boy's partial deafness. Before he was three years old a severe cold 
would make him hard of hearing, and now, at five years of age, the 



THE EARS. 



same trouble exists, and the deafness continues long after all signs of 
cold have disappeared. He has recently had a bad cold and earache, 
and he has remained hard of hearing so long that we are anxious lest 
his trouble should become permanent and past relief. He has never 
had much earache or any discharge from his ear. Is there danger of 
its becoming permanent deafness? Can we do anything to prevent 
this? He has always been a delicate child, having little endurance. 
His colds always take a croupy turn, and but for constant doctoring 
would terminate in spasmodic croup. 

Adams, Mass. O. B. M. 

There is always danger of permanent deafness under 
such circumstances. Catarrhal troubles are probably the 
commonest causes of deafness, and they are very active in 
just such delicate children. The child should certainly be 
taken to a physician, who, by advice as to his general regi- 
men and by local treatment of his throat and nose may be 
able to prevent the advance of deafness. 



Prominent Ears. 

My little boy is nine months old and his ears seem to stand out 
more and more all the time. When he was younger he was a frail 
child, and I did not dare to do anything about it ; but now that he is 
rugged can I not correct this feature by tying them back in some way? 
He has otherwise a handsome face. 

Hartford, Conn. M. D. H. 

It is probable that persistent bandaging might press the 
ears flat ; such treatment is successful in arresting the 
growth of the feet in certain classes of women in China. 
But we are entirely certain that we would not allow any 
such thing to be done to any child that was underour 
care. The object to be gained is of trivial importance com- 
pared with the persistent discomfort — running over months 
or years — that must be inflicted upon the child. When an 
ear projects as the result of an inflammation the case is dif- 
ferent, as slight pressure for not a very long while at a time 



170 NURSERY PROBLEMS. 

tends to replace the ear in its normal position. We might 
add, however, that inasmuch as the projecting ears give 
much distress to you, it might be proper to try one of the 
caps of tapes sold in the shops for producing pressure on the 
ears. They do not so closely cover the head as an ordinary 
cap and are less objectionable. But even with these we 
think that evidences of discomfort should be watched, for as 
we believe what we have said above on this point is correct. 



Large Ears. 



"Little pitchers have big ears." Unfortunately for my dear 
little girl of seven years, hers are large, physically and metaphorically. 
They stand out like handles. It is not hereditary, and I am anxious 
to correct it. Can you help me with your advice ? When I tie rib- 
bons over them to press gently she complains of soreness in a short 
while. Am I in danger of doing an injury to the internal organ by 
pressing externally? I am anxious to free her from the misfortune of 
prominent ears in later life. 

St. Louis. L. M. G. 

We can help you with advice, and it is to let the ears 
alone. Any pressure you make is far more likely to irritate 
the ears and thereby increase their want of beauty than to 
improve their appearance. The ear, for some reason or 
other, sc-ems to be considered a part of the body that can be 
trifled with. Very few persons would think of meddling 
with a nose that was not shapely or with lips that were ill- 
looking, but the ear is practised upon in various ways. It is 
hard to say why the wearing of rings in the ears should 
have survived the kindred mutilation of the nose and lips. 
Time may improve the set of the ears, and, at all events, 
the arrangement of the hair will improve their appearance 
far more than anything you can do to them. 



THE EARS. 



Tampering with the Shape of the Ears. 

"What would you advise me to use to make my baby's ears stay 
close to her head ? She is five months old, and her ears have j ust be- 
gun to stand out. 

Geneseo, N. Y. F. 

A close cap has been recommended, and is the least ob- 
jectionable thing we know, but we believe that treatment in 
such cases is usually worse than the disease. When a child 
is laid to sleep on one side on a firm pillow and occasionally 
turned, the weight of the head makes about as much pressure 
as can be judiciously applied. As the child gets older and 
rolls about on the face, back, or in any position, this plan is 
less efficient. Then the cap or a light band, as of flannel cut 
bias, tied about the head, will have some influence. But, as 
already said, we doubt if the inconvenience to the child of 
the treatment is not worse than the disfigurement, particu- 
larly as female headgear and style of head dressing ordina- 
rily partly overcome and partly hide the latter after the age 
of vanity is reached. 



THE HAIR. 



Thin Hair. 

I have reason to believe that my little girl, now three and a half' 
months old, has inherited a weak growth of hair. Can 1 do anything 
now, or a little later, to strengthen the head and roots? 
Brooklyn. C. H. S. 

It is too soon to be anxious about the child's growth of 
hair. She may never have an abundant growth, but its 
present thinness is no evidence to that effect. The greatest 
variability exists in regard to the time when the hair be- 
comes thick. We have seen children at birth whose hair 
was so abundant as to need a regular toilet, and who, at 
three months of age, looked as if they were wearing wigs. 
On the other hand, we know adults whose hair is very thick 
who were practically bald up to two years of age. 

Nevertheless, as you are anxious, we may give you some 
hints as to what to do and what not to do. If the hair had 
fallen out from an illness or from a disease of the scalp, some 
medication would be advisable ; but in such a case as you 
describe it certainly is not. What you have to do is to give 
the scalp the best possible chance to grow the hair. See 
that the scalp is always clean ; that is, free from dandruff, 
from the flaky deposit often met with (seborrhcea). See also 
that the head is not heated nor unnecessarily covered. But 
in giving it this attention do not irritate it. Do not rub it 
roughly nor use much soap upon it. Wash it gently, dry it 
gently. Remove any deposit upon it by very gentle friction 
with a finger anointed with vaseliue or any perfectly bland 
oil. Use a very soft brush in arranging the hair and avoid 
combs altogether. Adhere to the same gentle precautions 
after the child is older, and you will have done, in our judg- 
ment, the best that can be done. 



THE HAIR. 173 



"Washing the Scalp. 

When a child's scalp seems perfectly healthy and there is a good 
crop of hair, how frequently should the entire head be washed to in- 
sure a continuance of health? Also, with a predisposition to catarrh 
of the head, is there danger in washing, if the hair is thoroughly 
rubbed till it feels dry? 
Lake Valley, N. M. A. P. H. 

Often enough to secure cleanliness of the scalp, which 
may be determined by frequent careful examination for 
dandruff, etc. Instances occur where the " catching cold " 
seems to be directly dependent on the washing of the head ; 
but as a rule it is safe to wash the head, if the washing is 
done in a warm room and the hair is thoroughly dried di- 
rectly afterwards. 



The Use of Soap on the Head. 

For my two children I have had different nurses, and both have 
said : "Lather his head with soap every morning." My three-months- 
old baby's head is always white and clean, and I have washed it with 
"Cuticura" soap every morning, using a little vaseline once a week. 
I notice that for a few days after using the vaseline the scalp is just as 
clear as his little face, and then the skin begins to look dry. I think 
the use of soap so often tends to dry the natural oil of the hair. "What 
do you tli ink .' 

.Y. //■ Britain, Conn. B. A. B. 

For some weeks after birth the " lathering " has a good 
effeel in dislodging (lie secretion of the scalp, which is then 
often excessive. After a while it is not necessary to use soap 
every day in the head-washing, two or three times a week 
usually being enough; but if any scurf begins to form the 
daily use of soap can be resumed. 



174 NURSERY PROBLEMS. 

Tampering with the Color of the Hair. 

I should be greatly obliged if I could get information as to how 
to grow Baby's hair gradually darker. His eyelashes being very 
light, I fear his hair will remain about the same. Is there any efficacy 
in cold tea ? 
Morrillville, Neb. M. C. R. 

We have no advice to offer except that you should care- 
fully abstain from all attempts to change the natural color of 
your child's hair. No attempts on your part will effect any- 
thiug but damage to the hair. The cold tea acts only by 
staining the hair already grown. There is a very strong 
tendency for children's hair to darken after two or three 
years of age. Most mothers would rejoice in the blonde hair 
of a baby. 

Concerning Bangs. 

I would like to hear from you on the subject of "bangs." Does 
the wearing of the hair in this way cause it to grow down on the fore- 
head? To my way of thinking it is the prettiest fashion for a child's 
hair, but if it tends to a lowering of the hair line it might be undesir- 
able, as by the time the child is grown, high, bald fronts may 
again be "the style." 

Hedrick, Iowa. L. W. E. 

Hair grows only where hair follicles exist. Therefore it 
cannot be made to grow anywhere by any direction of 
brushing. But it is possible that a tendency of the hair to 
hang in a certain direction might be favored by brushing. 
Nevertheless we believe that "banging" does not tend to 
produce this peculiarity. No such peculiarity has developed 
in men who as children had banged hair. There is an enor- 
mous tendency to attribute effects to causes to which they 
had no relation whatever. It is not probable that the "high, 
bald fronts " will ever be fashionable for long for women, as 
the combined suffrage of civilized people from Horace's day 
to ours has voted them ugly. So you need not worry about 
girls' bangs. 



THE HAIR. 



Unhealthfulness of Long Hair. 

I would like to ask your opinion concerning the desirability or 
healthfulness of long hair for young children. My little hoy of three 
years has very heavy hair, long and curling. One friend says : " Oh ! 
don't have it cut, it is so beautiful. " Another remarks, with a serious 
air : " His hair is lovely, but you should have it cut ; it is doing him 
great harm." He is a sturdy little fellow and has seen very few sick 
days. 

Cuyahoga Falls, 0. H. H. 

So long as the hair is healthy we see no reason for med- 
dling with it. It can be weakening only by its excessive 
rapidity of growth. To cut it would not lessen this. The 
superstition — for it seems no more to us— that abundant hair 
is weakening is very prevalent. No doubt an over-thick 
head of hair may be annoying in hot weather, but we be- 
lieve the notion of its debilitating power is due to the fact 
that persons of a peculiar type of feeble constitution are 
sometimes very hairy. There is one disadvantage of long 
hair on the neck we may mention, namely, the exciting of 
perspiration in that region and a tendency to chilling and 
"catching cold " as a consequence. 



THE FEET. 



Confining the Feet. 

Do you approve of the plan of leaving tiny feet uiiconfined by 
little shoes until the wee one attempts to stand ? 

Mendocino, Cal. E. B. S. 

Yes, a wide, warm stocking is enough until the baby be- 
gins to use its feet for walking or creeping. 



Incipient Corns. 

1 have always been very careful about my little Marjorie's shoes, 
that they should neither pinch nor rub, and she wore moccasins for a 
long time. She is now three years of age, and on the little toe of each 
foot there is a decided corn, the size of a pin-head. Is there no way 
in which I can cure them, so that she need not be troubled with them 
always ? 

Oakland, Cal. G. C. 

There must be some mistake. Corns never come unless 
there is pressure or friction, and nothing can permanently 
cure a com so long as the pressure or friction continues. A 
shoe may be very large and yet produce corns because its 
shape is not right. We have seen many moccasins of such 
faulty shape that they could not fail to produce irritation. 

First of all revise the question of shoeing. See if the 
shoe holds neatly to the ankle and hinder part of the foot ; 
see next that there is plenty of room fur the toes not only to 
go in but to expand and play as the foot is moved. Often it 
is requisite to get shoes two or three sizes too long in order to 
secure the necessary width. In the fitting of the shoe lies 
the whole matter. 



THE FEET. 



The relief of an already acquired corn may be accom- 
plished best by first paring, then applying to the surface a 
solution of salicylic acid, say one part to eight of water, and 
after a day or two scraping away any part that has been 
softened by the application, and repeating this until the 
corn is removed. 

The corn too may be protected from friction by means 
of a plaster with a hole of suitable size in it, the plaster being 
so applied that the hole falls immediately over the corn. 
For children's feet these plasters are best made extempora- 
neously from several layers of the ordinary adhesive plaster 
to be found at drug stores. 



Distorted Feet. 

fl) "What is the remedy, as well as prevention, for misshapen 
feet? 

(2) Why, if the baby-foot is shaped rightly (the toes slightly 
spread, and the weight apparently evenly divided over the sole of the 
foot and on the bottom of each toe), when shoes have been worn for 
a few years, does the shape of the foot change and the ends of the toes 
turn downward, the joints pointing upward? This isthe way the feet 
of my oldest boy, aged 6, and my girl, aged 3, have changed, although 
they have always worn shoes at least one-fourth of an inch longer 
than their feet. I cannot but feel that the trouble is in the width. 

(3) Is it lack of sufficient length or width that is to blame for the 
immense joint, that sometimes inflames, on the inside of the foot ? 

Cranford, N. J. M. C. H. 

(1) The remedy lies chiefly in the wearing of the same 
kinds of shoes that would have prevented the distortion in 
the fust instance. But after a certain degree of displace- 
ment and rigidity has occurred other management is nec- 
essary. The subject is too wide to be treated of in the space 
at our command. 



178 NURSERY PROBLEMS. 



(2) We are not sure that we understand correctly what 
is intended. There is a crumpling up of the toes and the 
thrusting of one under another, due to the shoes beiug short 
or too narrow and pointed ; this change is a familar one. 
But we think you mean a change which is natural and 
proper, within limits — namely, that the habit of springing 
upon the toes in walking gives to them, particularly the 
outer ones, a slight curve upward, with some enlargement of 
the bulbous extremity. You can re-examine the children's 
feet and see which change you have to deal with. If the 
toes are crowded together and the imprint of one is left 
upon another, the shoes have done at least a part of the dis- 
torting. 

(3) Insufficient length may have some share in it. But 
the deformity is created thus : A shoe, the inner margin of 
the sole of which turns outward — as is usual in shop-shoes 
— at the toe-joint crowds the great toe towards its fellows ; 
this distorts the toe-joint, pressure is made upon parts of the 
joint not well prepared for it, then the narrow upper chafes 
and sets up an inflammatory process, which ultimately re- 
sults in chronic thickening of the soft parts, and even of the 
bone. These distortions sometimes are so extreme as to ren- 
der the cutting out of the joint necessary. 



Ingrowing Nails. 

Can you tell me of some cure for ingrowing toe-nails, and also 
what is liable to cause them ? It cannot be tight shoes in the case of 
my two-year-old, as I have always been especially careful to have his 
shoes roomy and comfortable. He seems to suffer from them, and I 
feel anxious to help him by some simple means, if possible. 
New York. A. N. S. 



THE FEET. 179 



The mischief done by shoes is less from small size than 
from faulty shape. It is, of course, possible that au ingrow- 
ing nail may not come from tight shoes, but certainly 
ninety-nine cases in a hundred are due to the shoe pressing 
the toes together. The great toe most frequently suffers ; it 
is crowded against its neighbor, the flesh is pushed up and 
laps over the nail, and the margin of the nail, being crowded 
toward the centre of the toe, turns downward and so grows. 
Sometimes, however, there is no fault in the nail itself, 
simply in the crowding up of the flesh, which thus becomes 
irritated under the pressure. If a foot has never been 
crowded, the sides of the toes are rounded as at birth, and 
as the lingers remain through life. Actually it is rare to see 
a foot some of the toes of which have not left their imprint 
upon their fellows from this lateral pressure. Keep the toe 
that is in trouble separated from its neighbor by a folded 
piece of linen put between them — slightly oiled if there is 
sign of friction against the linen — and the trouble will 
probably be relieved. If necessary, the down-growing cor- 
ners of the nails may be raised by the thrusting under of a 
pledget of soft cotton. In paring the nails do not cut off 
the corners, but cut the nail square across. These corners 
should protect the flesh ; if cut oh" the tendency to burrow 
is increased. 



THE CARE OF THE CHILD. 



Rocking The Baby. 

What are the physiological objections to rocking a baby? Is it 
likely to produce congestion of the brain ? 

California. C. P. 

The objections, in the main, are not physiological. We 
do not believe that gentle rocking is, save in exceptional 
cases, harmful. liut, on the other hand, it is not beneficial. 
The simple holding of the child, by the support and warmth 
given, is as quieting. The chief objection to rocking a child 
is the habit that is formed of going to sleep in an unnatural 
way. Sleep comes naturally to the tired child as soon as it 
is free from discomfort and is left alone. In saying the 
above it is not intended that the jolting and violent oscilla- 
tion of a child whose stomach is full are harmless ; we believe 
that favors indigestion. 

Changing Wet Diapers at Night. 

There is one subject upon which I would like to have your advice 
and experience. It is in regard to changing the wet diapers of a 
young baby during the night. 

There is no question in my mind concerning the rights of the case 
if the mother is unable to nurse her child, for then her unbroken rest 
is not so important to her ; but if she does nurse her baby, which one, 
mother or child, should be first considered? I attended to my first 
baby faithfully in regard to the changing of diapers, but it was often 
very hard to arouse myself sufficiently to do so and I have since 
thought that if I had considered myself a little more and the child a 
little less I might have had a more abundant supply of milk for her; 
but I would not bear to think that the dear little one was at all un- 
comfortable. Now, with a second one coming, I should like your 
advice. 

Chicago. M. L. D. 



THE CARE OF THE CHILD. 181 



No fixed rule can be given for such things, as circum- 
stances vary. But ordinarily, if the baby is well and 
securely covered, it will be safe enough to let it alone until it 
is sufficiently uncomfortable to wake, when you will prob- 
ably also wake, or until it is time to nurse the child. Ex- 
ceptions to this occur, as, for instance, when the skin is very 
tender or shows signs of irritation ; or when a child is very 
restless and uncovers itself. 



Sitting Up in the Chair. 

Much discussion has been given in our household to the subject of 
setting up his lordship, aged three months, in his chair. Grandma 
Is'o. 1 sat up all her children at that age and proposes that we do so 
■with this one. Grandma No. 2 thinks the idea preposterous and 
prophesies curvature of the spine. Old-maid blue-stocking Auntie 
proves it is inj urious with a lecture on the softness of an infant's 
bones, and says he must not sit up inside of six months. Papa and 
Mamma think a little sitting up at different times in the day judicious 
and strengthening ; that the answer depends much on the strength of 
the child ; that one who holds his head up quite stiffly and firmly may 
be allowed a change of position. "Will you condescend to act as um- 
pire? who, if any, is right? 

California. Pacific. 

The age at which a child can sit up varies much, and 
depends, as you say, upon its strength. We do not like 
chairs for such young children, because of their want of even 
support and their insecurity. A child should be allowed 
change of position from birth and change of posture as soon 
as he can change it himself or shows a desire to change. To 
this end we like to bolster a baby up, on a bed for instance, 
with pillows. His head and trunk are then well supported, 
and the change becomes a pleasure and not a tax. 



N UBS E R Y PR B L E MS. 



Baby in the Corner. 

Do you think it injurious for Baby to sleep in the corner? Our 
room being very small, it is a case of necessity that Baby's crib should 
be in a corner. We always have one of the windows raised several 
inches at night for ventilation. 
Altoona, Pa. E. B. H. 

There are corners and corners. If a room is badly venti- 
lated, corners are ordinarily the least ventilated parts. If, 
on the other hand, the room is one, such as is often seen in 
poorly constructed country houses, which is the arena of 
contending draughts, a corner may be the least dangerous 
part of the room. A small room with a window open ought, 
we should suppose, to be sufficiently ventilated to render the 
air in the corners safe. Another aspect of the question is 
this : If the corner be one between two external walls, it is 
likely to be chilly, if not damp ; an inside corner made by 
lath aud plaster partitions would not be open to this objec- 
ti.>n. As your room is small, it presumably has sufficient 
light as well as air. 



Playing on the Floor. 

I have two little ones, the elder four years of age, and the younger 
just walking alone. Our house is heated by a furnace, and there 
always seems to be a cold draught upon the floor, where my children 
are inclined to spend most of their time with their toys. Can you 
suggest a plan whereby I cau manage to keep them amused off the 
floor, or is there any way of stopping the draughts? 

Montclair, X. J. L. I. D. 

While heated air rises and cold air falls there must 
always be a chill current near the floor. Draughts from 
without may be partially excluded by weather-strips and 
sand-bags, but Baby sitting on the carpet is almost sure to 
take cold in bitter weather. A cheap mattress, covered with 
a quilt or shawl, makes a safe corner for him on windy days. 
One mother had a sort of dais or platform, six feet wide and 



THE CARE OF THE CHILD. 183 



six inches high, mounted on rollers and set against the wall 
of the nursery, for "Baby's room." In default of 
these conveniences, give the twain chairs and low tables of 
their own, and teach them to use them instead of sitting on 
the carpet. 

The Effects of "Jostling About." 

Will you tell me if you think it injurious to the nervous system 
of infants under six months of age to be jostled about in baby-car- 
riages, baby-junipers, etc.? 

Chicago. W. B. A. 

"We do not know that such jostlings are injurious to the 
"nervous system," as physicians use that name— that is, in 
its anatomical sense — but we believe they do increase the 
timidity and excitability of children, or, in other words, 
make them "nervous," especially if already inclined that 
way. We do not, for various reasons, think a baby-jumper 
lit for a child under six months of age ; and at any age a 
child's carriage should be trundled with care and without 
unnecessary jolting. 



Rapid Carriage-Driving for very Young Chil- 
dren. 

Is it wise for babies to be driven over country roads with fast horses 
at the age of six weeks or two months ? 

Randolph, Mass. Maiden Aunt. 

rjnless the roads are unusually smooth or the vehicle 
unusually easy such exercise is undesirable. It is compar- 
able to the jolting method of our grandmothers when a 
rockerless chair was made to act as if it were a rocking- 
chair, [fa young child is taken in a vehicle, it should be 
snugly held againsl the breast if rapid driving is necessary. 
Under such circumstances it should be protected until it is 
old enough and strong enough to steady itself. 



184 NURSERY PROBLEMS. 



A Playground on the Roof. 

Will you assist me with the best practical device tor enclosing 
the roof or roofs of our Day Nursery in a substantial and safe manner, 
so that we may supply our children with air and sunshine without ex- 
posing them to danger? The yard is not fit for the purposes of 
recreation. Last summer the Nursery was open every day, but its 
usefulness was greatly curtailed for want of a suitable playground. 
Philadelphia. S. 

We are not quite certain as to the meaning of the word 
"enclosing" in our correspondent's inquiry. If she refers 
merely to a fencing-iu of the roof to preveut the children 
from falling off, the best device would be a guard-railing of 
forged iron, such as is manufactured in all ornamental- 
iron works, of any desired height, and with bars placed 
as close together as may seem necessary. Of course it is 
essential to select a railing so constructed that there will 
be no danger of the little ones clambering on or over it. If, 
on the other hand, our correspondent refers to a superstruc- 
ture on the roof, the design will depend largely upon local 
dimensions, and with the information on hand we cannot 
give more than a few general suggestions. Any arrange- 
ment for converting the roof into a safe playground for the 
children will depend, in the first place, upon the season 
during which it is to be devoted to such purpose. It is quite 
evident that if the roof is to be used in summer only, the 
structure need not be of such a substantial character as 
would be required for a playground used all the year round. 
In the latter case the method of construction should be 
similar to that employed for "sun-baths," and particular 
care would then have to be bestowed upon the question of 
heating and ventilation. Fur summer use only, the simplest 
device would appear to be a strong canvas or tent, stretched 



THE CARE OF TIIK CHILD. 



horizontally at a suitable height across the whole roof, and 
supported by stout wooden posts, or, better still, iron rods, 
securely fastened to the parapet walls of the roof. Such an 
arrangement would protect the children and nurses from 
the direct rays of the sun, while freely admitting the fresh 
air. It might be desirable to have some protection against 
strong winds in the shape of side-awnings. The whole ar- 
rangement would correspond to that used to convert the 
deck of an excursion-steamer into a shady but airy sitting- 
place. The question of the means of access to the roof calls 
for special attention. There should be a regular stairway, 
and not the usual ladder-like approach. We would, fur- 
thermore, recommend a wooden flooring over the tin roof, 
for we consider the latter as unsuitable for a children's play- 
ground. The floor should be laid so that the water will flow 
off readily, to prevent dampness and decay. 

For a permanent structure for use in all seasons a frame- 
work of timber or iron should be constructed on top of the 
roof breast- walls, securely fastened to them, and covered by 
a roof, the construction of which would depend upon its 
width or span ; the sides and roof to consist of large panes 
of very thick window-glass, able to w ithstand a heavy w ind- 
pressure, to cany the weight of snow, and to resist the de- 
structive force of a hail-storm. There should be a sufficient 
number of side-windows to secure a circulation of air, and 
ridge ventilation may also be desirable. Arrangements 
should be made for keeping out the scorching rays of a mid- 
summer sun by providing roller-shades at the sides and 
under the roof, fastened so as to move in a manner similar 
to those used in photographic galleries. 



THE BATH. 



Comprehensive Questions about the Bath. 

I am the mother of five children, the oldest of whom is eight years 
old this summer, and another is very soon to be added to the number. 
One matter has troubled me for two or three years, and I would be 
glad of a solution. 

It is about the bath. All seem to take it for granted that the bath 
is administered to the child on first rising in the morning. Since my 
family has been so numerous I have found it very inconvenient to do 
this, and have therefore changed to just before their supper — i. e., 
about 5.30 p. m. 

(1) Is there any objection to this ? And ought not the tempera- 
ture of the bath to be warmer than if administered on rising in the 
morning? If so, how much warmer ? I would be best pleased with 
figures, as I always use the Fahrenheit thermometer. I know that, of 
course, the bath is primarily for cleanliness and nothing else ; but I 
am also persuaded that when used daily it becomes a powerful agent 
in strengthening or weakening the child. 

(2) I fear I give it too warm, but do not know. My oldest has 
it at 92° and my one-year-old at 97°. But I do not use an "immer- 
sion " bath with the water "up to the neck.'" They sit in the water 
from two to four inches deep, except once a week, when they have it 
about eight or ten inches deep, and two or three degrees warmer. On 
these occasions the two girls go in together — in our big bath tub — and 
the two boys together afterwards (Baby has not yet entered the "big 
bath," as they call it), but ordinarily each is bathed alone, and in 
reverse order of age, a little fresh water being added before each new 
occupant arrives. I cannot think my way is very bad, because my 
children have always been rather noted for their uninterrupted good 
health ; yet I fear lest by too warm a bath I may be gradually weaken- 
ing instead of strengthening them. A deciding word from you on 
this subject would be a great relief. 

(3) Further— What should be the temperature of a baby's first 
bath? (I have seen it stated at 102°, 100° and 98°.) How long 
should this same temperature be continued? How fast should this 
temperature be reduced, and to what point should it be reduced in one 
year ? What should be the temperature at two years of age, three 



THE BA TH. 



years, etc. ? How soon should the reducing process stop ? I see that 
one old authority — Dewees, 1833 — speaks of reducing the temperature 
one degree each month for the first two years, beginning at 98° — thus 
reaching 74° by the completion of the second year. Or is it a good 
plan to reduce ten degrees each year for four years, begiuning with 
100°, thus reaching 60 a at the end of the fourth year ? 

Yokohama, Japan. A. T. H. 

(1) There is no objection to the evening bath, and its 
temperature need not be warmer than that of the morning 
bath. 

(2) We think you would do better to give your baths 
from five degrees to seven degrees cooler "all along the 
line." An eight-year-old child ought, at least, to stand a 
reduction to 85° F. If he went into the sea it would be far 
below that mark if your climate is like ours, and he woidd 
enjoy it. When the sponge bath is used a child of two can 
generally use water of the temperature of the room — say 68° 
or 70° F., on an average, in this climate. 

(3) The very first bath is to remove the greasy deposits 
found at birth on the skin, and is usually between 100° and 
105° F. But the daily bath need not be above 100° F. ever, 
and we think, except for feeble children, 98° F. is preferable. 
Dewees 's rule is safe for strong children, at least for sponging. 
If in any ca.se there is doubt, a reduction of a degree every 
two months may be safer. But this rate of reduction we 
would not continue indefinitely, for Dewees's rule would 
take us to 50° F. at four years, which is too low for most 
children unless for quick sponging. Very much depends 
as to the effect of a bath upon how it is given. For instance, 
if a child in good health is quickly sponged in cold water 
and dried, there is usually a wholesome reaction directly. 
If a bath is given in a tub large enough for the child to romp 
in, much the same reaction follows, even if the water is cool. 
But if a Child were simply to sit in water which was poured 



NURSERY PROBLEMS. 



from u sponge over the upper part of the body, the same 
temperature of water could not be so long borne, as there is 
the repetition of the slight shock of the douche, while there 
is no muscular exercise to excite the reaction. 



The Proper Temperature of the Bath. 

We have a babe about a year old, and every morning we place 
the small bath-tub full of water in the large one in the bath-room, that 
he may splash vigorously for a few moments. How warm should the 
water be? I have been told it should be 90°; but would not 
a bath every day at that temperature be weakening rather than invig- 
orating ? I think it should be as cool as the child will go into pleas- 
antly — certainly not over 80°. Am I right? 
New York. A Lover of Babies. 

A bath in which the thermometer stands at ninety de- 
grees when the child goes into it cools sensibly and rapidly 
with the splashing of the water and the action of the air of 
the room on the surface. There is no danger in giving your 
baby such an immersion daily, unless you allow him to re- 
main too long in the tub. As, in our opinion, immersion in 
the tub is only supplementary to the washing of the body 
with the rag or sponge, and, except when the child is ill, has 
no special virtue beyond completing the cleansing operation, 
there is no reason for keeping the child in the water more 
than a very few minutes. In so short a time no weakening 
effect can ensue, nor can anything be gained by a lower 
temperature than 90 degrees. 



The Plunge-Bath. 

I have a question which I should like to see answered. Up to 
what age do you think a healthy child should be given a daily 
plunge-bath? Is it weakening? I am careful to have my room 
warm and the water only warm. My little girl enjoys such a bath 
hugely, but I am in doubt as to how long it should be continued. 
Chicago. M. E. S. 



THE BA TH. 139 



The only reliable test of the good or ill effect of a bath is 
the reaction that follows it. If the child enjoys it at ihe 
moment, and is after it warm and active, it is probable that 
the bath agrees with it. If the child is fatigued or drowsy 
and disinclined to exertion, or is troubled by indigestion, 
after it, the bath is probably a disadvantage. There is no 
fixed rule. But a plunge-bath should of course be brief and 
never be takeu ou a full stomach. 



Dread of the Bath-Tub. 

I have had a great deal of trouble with my baby, who is six 
months and a half old, on account of his dread of the bath. I have 
made two attempts with the little bath-tub, but he screams so and 
seems so evidently frightened, that it has been given up, and he is still 
washed upon my knee as in his youngest days, though a more lively, 
vigorous baby could not be found This makes the daily sponging 
more than ever troublesome. 

Collingwqod, Ont. G. A. .N". 

There is no real need for a child to be immersed in his 
bath. It is simply done to save labor. If the baby is afraid 
of the tub itself it is better to continue sponging until you 
can get him accustomed to the tub by letting him have it to 
play with. You can obviate the difficulty of washing a big 
baby on the la), by laying a rubber sheet on a little table or 
bench of convenient height, and letting him lie on it when 
he is sponged. If it is only the immersion that is feared, 
let Baby be placed in the empty tub, warmed by previous 
rinsing with hot water, and there sponged. 



190 NURSERY PROBLEMS. 



Unfavorable Symptoms Following the Bath. 

I have a little boy of five, who, without being ill, is not very- 
strong. He easily takes cold and is very restless and nervous. I may 
truthfully say he is an exceptionally bright child for his age. I have 
been advised to sponge him off every morning with cold water, but my 
previous experience makes me hesitate about acting on the advice. I 
began washing his body with cold water two summers ago, but found 
that itregularly produced a certain shock upon him, and, instead of feel- 
ing invigorated, he seemed rather listless and looked pale for some 
time after. Now, do you think that under the circumstances I ought 
to resume the sponging-off ? And if you do, had I not better begin 
with lukewarm water, gradually accustoming him to colder? What 
ought the temperature of the bath-room to be to prevent the risk of his 
catching cold ? And how can I best promote the " glow " which I am 
told ought to follow the bath if it is to be beneficial ? 
Portland, Oregon. E. -y[ 

It is assumed that " nervous » is used in the popular 
sense of the word to express an excitable or irritable tem- 
perament as distinguished from an equable one. It would 
be carrying us too far to discuss whether there might be a 
common cause for this state of things and the tendency to 
catch cold, but we take the questions up as they are pro- 
pounded. 

It is true that many persons gain an immunity, partial 
or complete, from the effects of chilling by the use of cool or 
cold baths. But as chilling, or even change of temperature, 
is not the only cause of symptoms known as " taking cold," 
this immunity only partly solves the problem. Again, it is 
not a universal, or even common, experience that the 
nervous symptoms of the kind we suppose our correspond- 
ent means are improved by cold baths. There is a weakness 
or want of tone for which the stimulating effect of the bath 
is, under proper-restrictions, beneficial. The circulation, the 
appetite, and the general condition improve, and the nervous 
system gains steadiness as a result. The test usually ap- 



THE BA TH. 



plied of this tonic effect is that the patient shall soon, if 
not inimediatelj', afterward experience a sense of warmth 
and comfort, and feel stronger rather than weaker. There 
are many persons who do not readily get up this glow ' and 
this leads to the answering of the last two questions. 

The temperature of the bath-room should be moderately 
high — 65° to 70° F., if the body is to be entirely exposed 
during the sponging. The glow and the protective influence 
desired are sometimes obtained in susceptible persons, who 
cannot easily bear the ordinary bath, in the following way : 
Common alcohol or some inexpensive liquor, either pure or 
diluted one-half with water, is used for the bath. The addi- 
tion to it of a little salt makes it a little more stimulating. 
If the child is delicate the clothing can be removed from a 
part of the body, say an arm, which is smartly rubbed with 
the spirits, and then covered, and another part is then treat- 
ed in the same way. The whole process takes but a few 
minutes, and a pleasant reaction usually results. 



Concerning the Necessity of a Daily Bath. 

Do you advocate the daily bathing even of delicate infants? 
Some professedly very knowing old ladies interdict this practice. 

Carthage. 



Every baby which is not distinctly ill ought to be 
washed all over daily. But there are ways and ways of doing 
this. If the child be very delicate substitute a rapid sponge- 
bath of warm water, carefully and tenderly given, for the 
plunge. Without cleanliness there can be no lasting phy- 
sical good. 



NURSERY PROBLEMS. 



Soap. 

(1) Is the use of soap necessary or desirable in daily baths ? 

(2) For children's use which is preferable, a good castile soap, or 
some of the numerous "scented" or other "fancy" varieties? 

Brooklyn, N. Y. H. K. 

(1) Only necessary at places where especial need of 
cleanliness exists — face, neck, armpits, seat and groins. 
But as the moderate use of bland soap is not harmful to 
most skins, it is easier to go over quickly the whole or most 
of Baby's body than to pick out spots for washing. 

(2) "Castile," if of good quality, is excellent. There 
are other excellent soaps made. But avoid scents. Your 
object is to clean the baby, and to know if it is sweet when 
you have finished you must avoid artificial smells. A clean 
baby is sweeter than any perfume. 



Diminishing the Frequency of Baths. 

(1) When shall Baby's daily bath be discontinued ? Never, I 
hear some say ; but suppose the mother's time and strength are very 
much taxed? 

(2) If a change is to be made, how many baths should be given a 
week, and are they to be given night or morning ? 

Buffalo. Young Mother. 

(1) You answer this yourself. It is to be continued as 
long as you can give it. It is given in the main for cleanli- 
ness, and is no more necessary at six months than at six 
years. The immersion is not a necessary part of the bath. 
A quick sponging does as well. 

(2) As many as you can give. If you can give only 
three baths a week, or two, or one even, give them. They 
are preferable in the morning, as a cool sponging, we think, 
is a protection against taking cold, and the exposure is more 
likely to occur by day than by night. 



CRYING. 



The Significance of Baby's Cry. 

This summer a little new baby is expected, and I want your ad- 
vice. When my last baby came I was anxious to begin his education 
immediately, but he was "colicky" and my nurse was indulgent, and 
I was anxious and troubled whenever he cried. You know the conse- 
quence. When my nurse left me, my hands were very full. Now my 
theory is that the baby, as well as its mother, is better if Baby is 
taught to lie in its cradle ; and I want you to tell me if I am right in 
insisting upon nurse putting Baby down immediately after necessary 
attention has been given, and letting it alone. 

What ought to be done with a wee few-days-old baby when it 
cries? It seems hard to let it lie and cry, and yet it seems wrong to 
nurse and fondle until the habit is formed, and then begin to break it. 
If I had a pain I am sure I should not want to be bounced about. 
Please advise me; for it will be hard to hold my own against the 
wishes of my mother and my nurse, especially as I am not very thor- 
oughly established in my faith. 
Pittsburgh, Pa. N. N. 

We have no hard-and-fast rule, but should be guided by 
this question — Why does the baby cry? If from pain it 
should be eased ; but as a rule you will be quite safe in let- 
ting it alone. If the baby has colic it is more likely to be 
comfortable if its abdomen is laid against a water bag 
partially filled with warm water than if "bounced about." 
The relief a child experiences in real colic from being held is 
from the warmth and pressure of the body of the mother or 
nurse. This warmth and pressure may be obtaiued as sug- 
gested. But if a child cries simply because it likes to be 
laid, nothing is gained by gratifying it. We believe that it 



194 NURSERY PROBLEMS. 

is the experience of most trained nurses that babies can 
nearly, if not always, be quickly taught to be quiet without 
fondling. The necessity of the child's being held usually 
arises not from the infant's needs, but from the custom of 
nurses to fill vacant time in the pleasant task of fondling 
the child, till the habit is formed. Your experience is a very 
common one. 



Inordinate Crying. 

One of my little girls, five years of age, who is just as healthy as 
her four brothers and sisters, and has just as much reason to be 
satisfied with the world, has been crying, with more or less interrup- 
tion, ever since she entered it. I know that all children have their 
crying-spells, but hers surpass in duration all reasonable bounds, and 
they are — I say it in spite of the dictum that no child cries from mere 
love of crying — seemingly often without cause. That this is due to no 
physical defect I know from the physician. Must I then believe the 
trouble to be of a moral nature? 

Orange, N. J. K. H. 

Try moral remedial measures. For example, make her 
comprehend that such and such pleasures are contingent 
upon her self-control. Mark crying-days with a black cross 
in her calendar as those on which her indulgence in this 
luxury lost her a coveted good. Treat her habit as a disease. 
Undress her and put her to bed ; withhold dainties, playfel- 
lows and amusements, and impress upon her mind that her 
crying is the cause of the regimen. This trick of crying is 
easily acquired, and the habit may become very obstinate. 
An iugenious mother cured her five-year-old of fits so pas- 
sionate as to threaten convulsions by throwing a handful of 
cold water into her face when she began to scream. The 
child, whose infirmity had been pronounced incorrigible, 
would suspend operations with ludicrous suddenness when 



CRYING. 195 



her mother moved toward the washstand. It may be, as 
often happens, that pre-natal influences have given the 
little one's disposition a warp in the direction you mention. 
Still, she should be broken of it. You would not hesitate to 
use surgical appliances to straighten a wry foot. 



Crying and Sedatives. 

(1) To what extent is crying harmless in babies ? The cry of a 
baby is its voice. If this were stifled it could not make known its dis- 
comfort or pain. 

(2) Should sedatives be given? When? In what quantities? 
What is a safe preparation ? 

(3) When an infant of a few days, say two weeks, sleeps well 
during the day, but cries at night, how can the natural relation of day 
to night be restored ? 

Brooklyn, X. Y. S. R. 

(1) This can be answered only in a general way. The 
baby has " no language but a cry," in one sense ; but it does 
not "cry for joy." If a baby cries, it signifies that things 
are not as it wishes in some particular. Of the various cries 
of infancy many are usually easily recognized, or at least 
have been catalogued by nurses long ago. Pain, weariness, 
sleepiuess, fright, etc., are among the causes assigned to differ- 
ent cries. To many children the cry is not harmful, but the . 
cause of the cry — pain and fright, for instance — is. We pre- 
sume our correspondent wishes to know when crying is of 
itself harmful. It rarely is so. Children occasionally " cry 
themselves boarse," and also, rarely, a fit of crying may ex- 
cite vomiting if the stomach be full ; but neither accident is 
very important. Of more importance is the fatigue and ex- 
citement dependent upon excessive crying. Violent fits of 
crying arc assigned us a cause of rupture (hernia) in infants, 
and perhaps correctly. It is not possible to describe the 



NURSERY PROBLEMS. 



various cries of infancy. Their interpretation is learned by 
watching the child. The main point is to make sure, if pos- 
sible, whether any removable hurt is the cause of the out- 
cry. See if pins are pricking the baby ; if it is too tightly 
diapered or clothed. Try also to see if it has colic or indi- 
gestion, and so on. 

(2) By "sedatives" we presume is meant not what is 
called such by physicians, but anodynes (relievers of pain) 
or hypnotics (sleep-producers). Neither the one nor the 
other should be given under any circumstances without 
medical advice, which should be specific as to dose and time 
and occasion of repetition. There is no safe preparation for 
infants or young children without such advice. 

(3) The process is often very difficult, and taxes the in- 
genuity of the nurse ; but usually the monthly nurse can 
get the baby well started, and she should, if she has been 
successful, explain her methods minutely to the mother. 
The secret of success is not in drugs, but in systematic and 
regular methods with the baby. 



WALKING. 



Turning-in of the Toes. 

I. 

What can be done for a twenty-months baby who shows a decided 
tendency to walking with toes turned in? She has not inherited the 
tendency, and I have tried to be careful to have her shoes large enough, 
though she grows so rapidly that her toe generally finds the end before 
the new ones are bought. 

Connecticut. H. S. 

II. 

My baby, who is fifteen months old, turns in his left foot when 
walking. Can you tell me how to remedy it ? When he sits down 
with his feet straight on the floor his legs and feet are perfectly straight, 
so I think it must be a habit with him to turn in his left foot. 

Bardstown, Ky. M. 

I. 

Examine carefully (best when Baby is naked) to see if 
the turning-in is at the ankle — or, more exactly, at the joint 
between the instep and ankle — or whether the whole limb 
rolls in from the hip. If the trouble is in the foot, perhaps 
some support is necessary, but that will depend upon the 
degree of the twist. If the trouble is at the hip it may be 
only the natural tendency to walk with the toes forward 
rather than outward. Rubbing and kneading of the flesh 
about the hip that makes the prominences of the buttocks 
may develop the muscles there and thus give greater power 
to turn out the lots. Such cases have a multitude of va- 
rieties and degrees, and the need of artificial support cannot 
he definitely determined from a short description. 



N J 'USER Y PR OBLEMS. 



II. 

The natural tendency to turn the feet in in walking is 
particularly marked iu childreu. It is often observed that 
some children turn iu the toes of one or both feet very much 
when walking, although no real club-foot or distinct disease 
exists. This peculiarity is often— indeed, usually— cured 
before adult life by the child itself when old enough to give 
its attention to it. If it is very marked it probably requires 
the action of some light, properly-constructed apparatus to 
overcome it. This can only be directed by some surgeon 
familiar with this kind of cases, and he can best advise you 
whether the condition is really of sufficient importance to 
need treatment at all. By yourself you can do little more 
than to call Baby's attention to the turning-in of the toes 
when he is old enough to understand you, and so prompt 
him to an effort at cure. 



Very Dainty In Regard to Her Heels. 

Our little girl, eight months old, wants to stand all the time on her 
toes, and it is hard to get her to put her foot flat down. Can we do 
anything to remedy this, or will she outgrow it? 

Charlotte, N. C. A. V. P. 

1 1 is rather early for the child to be making serious at- 
tempts at walking, and until she does the question cannot 
really be answered. You may find out something in this 
way : When she is sitting or lying take the limbs (one at a 
time) in your hands ; straighten the knee completely, so that 
the thigh and leg are in a straight line. Hold the limb thus, 
and press the toes and front of the foot upward, and see if 
there is any difficulty in bringing the sole to a right angle 
(or rather beyond) with the line of the leg. Do this several 
times to each limb until you feel quite sure what is the con- 



WALKING. 199 



dition. If you cannot easily bring the foot to or beyond the 
right angle, ask your physician to examine it. This is the 
best advice we can offer, as it may be only a trick of the 
child, or it may be due to some unusual rigidity of the calf- 
muscles. There are a number of ailments in which this 
drawing up of the heel exists. 



Weak Limbs. 

My baby, thirteen months old, has crept for some time, but does 
not try to stand at all yet or pull himself up, and does not seem to care 
to rest on his feet. As he is quite fleshy, is it best to let him partly 
rest his weight on his feet, and in this way teach him to walk ? Some 
of my friends think it would be best ; but as his ankles and limbs 
seem weak yet, I am so afraid of injuring them. Will you please 
give your opinion ? 
Jamestown, N. Y. A. C. E,. 

Do not hurry him at all. If he does not walk for six 
(or indeed twelve) months yet, it is better than putting a 
heuvy baby on his legs prematurely. A baby that creeps 
well is not without ambition and will get up as soon as it is 
safe. If his limbs are distinctly weak you may rub them 
and bathe them with salt and water, but do not urge him 
to walk at present. 



A Baby who Neither Walks nor Creeps at 
Twenty-one Months. 

My baby is twenty-one months old and does not walk nor has ever 
crept. He seems quite normal otherwise and usually healthy, having 
always been taken out-doors a great deal. Would you advise the use 
of a perambulator? 

Massachusetts. L- &• A. 



200 .V URSER Y PR OBL EMS. 

If the baby is "quite normal otherwise" in regard to 
bone-growth aud various kindred things, the perambulator 
would encourage him to try to walk. But you can also en- 
courage him to creep by engaging his attention with some 
attractive object and then leaving it near, but not too near, 
him on the floor, and so entice him toward it. But first ex- 
amine, or have your physician examine, if he is strong in 
the particulars alluded to. See if his head is firmly closed; 
see if he has teeth enough — he is entitled to sixteen at 
twenty-one months of age ; feel of his shins and forearm to 
see if the bones are as straight as usual ; notice if his joints 
— i. e., the ends of the bones — are larger than usual ; also if 
he is constipated, or fluctuates between constipation and 
diarrhoea ; if he is subject to sweating of the head. If he is 
all right, then encourage him ; if not, wait and have your 
physician advise you as to what is lacking to make him 
strong enough to begin walking. 



QUESTIONS OF DRESS. 



The Knitted Band; Getting Rid of The Pinning- 
Blanket. 

(1) Can you tell me how large to make the knitted bands for an in- 
fant ? I have but one child, and, as he was dressed the old-style way 
with many bands, I thought that I could do much better with the 
Gertrude suit. 

(2) I would also like to ask how they do with the pinning-blanket 
— make it like a skirt or leave it off altogether ? I suppose that you 
will tell me to let the band go after the first month or so, but my boy, 
now eight years old, had severe trouble with his bowels, and if 1 took 
off the flannel band he would be much worse. I also used the band to 
button the stocking-supporters on, using the supporters as soon as he 
was put in short clothes. He wore long woollen stockings, keeping his 
knees and legs warm. 

CharleUown District, Boston. C. J. 

(1) A knitted band should be rather loose ; one that is 
tight enough to hold up stockings is too tight. Its only use 
being for warmth, it should be wide enough to cover the 
whole abdomen, say from just below the breast to the hips. 

(2) One of the merits of the Gertrude suit is that it gets 
rid of the pinning-blanket. 



Knitted Bands of Saxony Yarn. 

I wisli to tell young mothers how I settled the question of bands 
for my baby. I knitted them of Saxony yarn, loosely, on medium- 
sized steel knitting-needles. They are elastic, and keep in place far 
better than flannel bands do ; they do not slip up or wrinkle, and if 
carefully washed do not shrink. They are knit in old-fashioned gar- 
ter-stitch in a strip, and then are sewed, or more properly are darned, 
together, so that there is no seam to rub. 

Oil City, Pa. S. B. 

This solution of the question is a very good one. 



N URSER Y PR OB L EMS. 



Silk or Flannel? — Seasonable Dress for a Five- 
Months-OId. 

(1) My baby is five months old, and has always worn long-sleeved 
and high-necked silk shirts, but I find that his arms and shoulders 
are generally cold. Shall I put flannel on him instead? 

(2) What should be the day garments for spring ? When sum- 
mer comes should I make any difference ? 

(3) When should I put short clothes on him ? 

St. Louis. An Inexperienced Mother. 

(1) Silk is cold -wear for winter, and, when damp with 
perspiration in summer, clings disagreeably to the skin, be- 
sides becoming almost as impervious as oiled silk to air and 
moisture, and thus hinderiug the action of the pores. Fine 
silk-warp flannel is better wear for all seasons, certainly for 
warm weather. Lighten his upper garments, should he 
suffer from heat, and exchange the damp for dry flannel. 

(2) The same as in winter, but of lighter material. 
Substitute short-sleeved and low-necked shirts for those he 
now wears when the heats of summer begin. Be careful 
not to leave off flannel skirt and band too early in the 
season. Wait for July days for this. 

(3) As soon as the warm weather is an established fact. 



The Rubber Diaper. 

Would you advise me to use therubber diaper for my baby during 
the coming summer ? She was six months old the middle of May, and 
I expect to put her in short clothes before the warmest weather comes. 
Saugerties, 2V. Y. S. 

We think the rubber diaper a detestable thing. We 
can imagine emergencies in which it might be tolerated for 
an hour or two, but cannot conceive any condition under 



Q UES TIO NS OF DRESS. 203 

which its habitual use is justifiable. It is simply a way of 
poulticing a child's hips all the time, the moisture beiug 
supplied by perspiration most of the time and by urine at 
intervals. If it is very necessary to protect yourself wear a 
rubber apron. 

The Gertrude Suit. 

(1) Do you advise a band of soft Jaeger flannel to be worn for 
warmth and not for support during the first year of the baby's life ? 

(2) In the Gertrude suit is there not a great deal of trouble expe- 
rienced from the clothes becoming wet or soiled, which might perhaps 
necessitate a change of the entire suit several times a day ? "Would it be 
better to wear a short shirt next the infant's skin, thus preventing any 
chill that might occur from the complete change of the suit, or could 
the Gertrude shirt be so made that the skirt of the shirt could be 
changed without removing the body of the shirt ? 

(3) Do you advise the use of heavy or light weight Jaeger flannel 
for the shirt of an expected February baby, the skirt being of the ordi- 
nary weight flannel ? Is not the Jaeger flannel preferable for the shirt 
and nightdress to any other material, such as Canton flannel or the ma- 
terial known as "domett" ? 

(4) How many Gertrude suits are considered necessary for a 
layette ? 

(5) Would the shirt of Jaeger flannel be sufficient for night wear? 
Philadelphia. X. 

(1) The band of Jaeger or other flannel is worn for sup- 
port during the early weeks of infant life, or while the 
abdominal organs are adjusting themselves to the proper 
performance of their functions. For warmth the wearing 
of the band may be indefinitely prolonged, and many chil- 
dren of three and four years use them. After the first 
month, we like the machine knitted band quite as well as 
the flannel, and it has the advantage of having elastic 
shoulder straps to help to keep it in place. 

(2) Among the many words of praise that have been 
spoken about the Gertrude garments, there has scarcely been 



204 NURSERY PROBLEMS. 

a complaint of inconvenience in managing them in regard 
to soil or wet. Every baby should have two napkins. 
While the clothes are long, the inner napkin should be 
folded shawl shape — as is customary — and besides being 
pinned with a large safety pin where the three corners come 
together, should be secured on each thigh, where the napkin 
laps over, by a small safety pin ; thus forming a kind of 
diaper drawers. By slipping the fingers between the thigh 
and the napkin, these edges can be drawn snugly together 
without making them too tight when the hand is removed, 
and much wetting and soiling of the clothing can be pre- 
vented by this simple device. The second napkin on a baby 
in long clothes should merely be folded once, wrapped 
around the body and fastened, and allowed to hang like a 
barrow coat between the body and the flannel. This also 
saves many unnecessary stains. Doubtless the first Ger- 
trude garment could be cut in two, and the skirt be attached 
by very thin flat buttons to the waist portion, making sure 
to bring the lapping where it would not be likely to irritate 
the baby's skin. But we believe this to be a needless pre- 
caution, if the above method of diapering be followed. With 
the Gertrude suit the process of dressing and undressing is 
so easy and rapid that a baby ought not to be chilled in a 
room sufficiently warm to make the change in at ail. Of 
course, a very thin cashmere shirt can easily be worn under 
the Gertrude suit if desired ; but we do not consider it nee- 



(3) We always prefer the light weights of all materials 
for infant's wear. Jaeger flannel is certainly preferable to 
Canton flannel or "domett" for the shirt and night dress ; 
but we do not consider it superior to a nice grade of all-wool 
flannel for the shirt, or to a very good and fine grade of cot- 
ton-and-wool flannel for the night dress. Even with careful 
washing, the Jaeger flannels full a good deal, and, with in- 



QUESTIONS OF DRESS. 205 

different laundrying, soon become so thick as to be unsuit- 
able for baby wear. 

(4) Where quick returns from the laundry may be had, 
three suits of Gertrude garments are a comfortable number ; 
but where washing may be or must be delayed, more are 
necessary. 

(5) It is desirable that a regular night dress of flannel be 
worn — at least until warrn weather — over the Gertrude 
shirt ; and the night dress should be long enough and full 
enough to button the hem together like a bag. This will 
keep the little legs and feet warm, at any rate, however the 
bed clothing becomes disarranged. 



Night Coverings. 
What shall I do to keep my baby-boy warm at night ? What- 
ever I do he will get outside the bedclothes. I fear that by doing so in 
winter weather he will get pneumonia. He has recently had a severe 
cold, taken in that way. A few weeks ago I put flannel night-drawers, 
with feet, on him, and consider them a very good article, but that is 
not enough covering. I have thought somewhat of making a large 
flannel bag to put him into, and yet that does not seem exactly a com- 
fortable thing. Perhaps some of your correspondents have already in- 
vented something of which they will give me the benefit, for I know 
some other children must have had the same bad habit which my little 

boy has. 

Brookline, Mass. A. 

Besides the sleeping-drawers we are in the habit of ad- 
vising one of two things : The careful securing of the covers 
by tapes or strong safety-pins— large sizes are made for the 
purpose- or the blanket bag you suggest. The latter, you 
probably Know, is the plan pursued by explorers and hun- 
ters in cold weather. As a baby's napkins must be changed 
at night, the bottom of the bag may "have a flap to button 
over, in which case it is really only a nightgown closed at 
the bottom. It should be made very wide* to permit free 
movement of the limbs. 



NURSERY PROBLEMS. 



The Night-Cap; Stockings at Night. 

Should a baby with little or no hair, inclined to perspire about the 
head and neck, wear a night-cap ? Should he wear stockings at night? 
Can any rule be given as to the amount of bundling and wrapping a 
young baby requires ? 

California. Pacific. 

We know of no use for night-caps. The child can be 
better protected from draught in other ways. The stockings 
are not necessary if the bed-clothes are suitable and kept in 
place. The only rule is evenness of protection and sufficient 
warmth without burdensome weight. 



Summer Dress. 

I should like to ask you how I shall dress my baby-boy of eight 
months in the summer so that he may be warm enough and not too 
warrn ; he seems to feel the heat very much. Would a Canton flannel 
nightgown that has been worn this winter be too warm ? Ought he to 
wear merino stockings, as he is doing now, or will cotton ones be 
better? 
Lebanon, Pa. E. M. C. 

A loose and ample garment, with shirt, napkins, and 
stockings under it, will be enough in hot weather. Cotton 
stockings have no particular advantage as to coolness over 
merino if the former are sufficiently stout to be of any use 
to a strong baby ; so we think you will find the advantages 
on the side of the merino, all things considered. The Can- 
ton flannel will not be too warm, but woollen flannel is more 
porous and generally more comfortable. If night-drawers 
closed at the feet are used no other cover is needed in very 
hot weather. 



QUESTIONS OF DRESS. 



Summer Night-Clothing. 

Will you kindly advise me what material for night clothes you 
would consider best suited to the needs of an eighteen months' child 
this summer, who will pass the season at the seashore and has yet the 
stomach teeth to cut? 

Medford, Mass. W. S. S. 

A light, fine, cotton-and-wool flannel makes the best 
summer-night garments. With proper washing it does not 
full, and it is in every way safer than muslin for the sea- 
shore and but little warmer. 



Clothing for Winter. 

What is the wisest way to dress a child in winter? T do not 
approve of the little thin white dresses, and want my little girl to wear 
fleeeed-piqu< : . 
Boston, Mass. E. P. S. 

The garments should be planned so as to make an even 
covering for the whole body, and should be such as to seem 
comfortably warm to you for your house and climate, with- 
out overloading the child. All babies and children in our 
winter should have thick woollen undergarments. The 
heaviest all-woo] merinos that you can find will not be too 
warm. They should be high-necked and long-sleeved, and 
long in the body. Long woollen stockings, held up by side- 
supporters, are an excellent protection, and, if possible, let 
the child wear flannel drawers also, for the skirts fly about 
and cannot be depended upon. The Legs of the drawers can 
be made separate to button on, if more convenient. Then 
comes the cotton waist, which helps to protect the chest 

and holds the llannel skill and drawers. The fleeccd-pi<|Ue 
would be comfortable, but, with an extra Manuel skirl and 
llannel Bacque underneath, the thin dresses can be made 



N UBS E It Y PR OB L EMS. 



perfectly safe. A few house saeques are useful when the 
rooms happen to be cooler than usual, but should not be 
habitually worn. 

For out-of-doors have a thick hood, or a hat which will 
cover as much of the head as a hood, with warm, broad ear- 
pieces, fitting closely, and a heavy cloak. If the child walks 
she should have thick soles and leggings. If she rides she 
should have plenty of blankets snugly tucked around her 
under those used chiefly for ornament. Warm mittens are 
very important, and care should be taken that they are kept 
on if the weather is cold, for the child cannot be comforta- 
ble if the hands are chilled. 



The Winter Outfit. 

Please to inform me how to dress my year-old boy this winter. 
He has worn since birth the " Gertrude " suits. What puzzles me is 
the Jaeger shirt, and whether he will be old enough to dispense with 
diapers. At what age do they put drawers on children ? Also, what 
kind of cloak and cap ought he to have? 

Cleveland, 0. Y. M. 

You could dress him in the Gertrude suit shortened, 
with the inner garments made warm enough for winter, or 
you could put him into regular woollen shirts and have 
waists to which to button woollen skirts, also the drawers 
when you can put them on. 

The trouble with a child of that age is to keep him 
warm about the legs. He should wear long woollen stock- 
ings fastened up high, and when upon the floor should have 
woollen creeping drawers. When out of doors, he can be 
easily wrapped up warmly in afghans, and should have a 
good warm cloak and cap made like a girl's hood, or else 
a hat with ruchings about the face and warm ear-pieces. 



QUESTIOXS OF DRESS. 209 



Some children younger than one year wear drawers. It 
is about as easy to begin at one time as another. You 
should have plenty of them and not expect the child to tell 
his wants, but be content with keeping run of the intervals 
for him till he gradually learns to tell. 

Jaeger flannel can be bought by the yard, and garments 
made therefrom in the usual way, if you prefer. 



Importance of Long Stockings. 

(1) I should like to put my baby in short clothes in June, and 
wish to ask what kind of socks I should put on him ? One friend says 
cotton, another says merino by all means through the first summer. If 
the latter advice be followed, will there not be danger in changing to 
cotton ones later ; or would this necessitate putting on cashmere ones 
as the cold weather approaches? 

(2) My oldest child wore merino and then cashmere stockings, 
but is subject to spasmodic croup. Is there any truth in the statement 
that woollen stockings cause a tendency to croup by making the feet 
perspire? If this be true, I want to guard against the second child 
being made a subject for croup. 

Tonkers, N. Y. B. S. M. 

(1) When the baby is put in short clothes he should have 
stockings long enough to cover the leg and knee and go 
higher yet if the napkins will permit. The short sock com- 
monly used on babies has no value except to keep the shoe 
from touching the foot ; it generally leaves the calf and knee 
bare if the child moves his legs enough to throw off his 
skirts. We arc persuaded that the secret of healthful cloth- 
ing is the uniform protection of the body; hence a method 
of dress that leaves open patches of the person between 
thickly-clothed ones is more hazardous than simple nudity. 
A child should not be burdened with clothes, but the pro- 
tect imi should be as evenly distributed as possible; hence 
the advice about the length () f the stockings. 



210 NURSERY PROBLEMS. 



As to materials, we prefer those that have a considerable 
amount of wool. "Merino" is a trade name for knitted 
goods containing both cotton and wool, apparently in vary- 
ing proportions. "Cashmere" we are not quite certain 
about, but we thiuk it is mainly wool with some cotton. 
The reason for preferring wool is that through it changes of 
heat and cold are less quickly felt. It has been found that 
light woollen fabrics make the most comfortable as well as 
the safest summer apparel. 

(2) We do not believe that croup comes from the cause 
assigned. If the shoe is sufficiently large the woollen stock- 
ing does not cause perspiration, and, as already said, a 
change of temperature or a draught of air, which are the 
usual causes of a check of perspiration, are much less readily 
felt through wool than through cotton. 



Stocking Supporters. 

What is the best means of keeping up stockings for a baby who 
still wears diapers ? 

Baton Rouge, La. G. L. W. 

Broad, soft elastic bands buttoned to the tops of the 
stockings and tied to strings stitched on the inside of the 
waist of the flannel skirt. After the child puts on under- 
waists attach the elastics to buttons set on the outside of 
these. 



Garters and Stocking Supporters. 

What do you consider best for children, the round garters, above 
the knee, or the stocking supporters attached to the waist ? 
Dundee, III. J. A. P. 



QUESTIOXS OF DRESS. 211 



The objection to the circular garter worn above or below 
the knee is, of course, that if tight it interferes with the free 
return of blood from the leg. The objection to the waist 
stocking supporter is that if tight it draws forward too 
much on the loins. Now, practically neither does harm 
if not too tight. If one tries to keep a silk stocking up 
next the skin or upon slippery underclothing, a tight garter 
of either kind is needed to keep the stocking free from folds. 
But as children dressed for comfort and not for show gen- 
erally in cool weather have drawers of woollen or some knit 
goods and stockings of wool or some substantial material, 
the stocking is readily kept in place with very slight pres- 
sure. Very little, for instance, is required to keep the stock- 
ing of the bicyclist or sportsman in place. In our judg- 
ment, the stocking supporter is preferable if the garter must 
be tight, but if the child is properly dressed it makes little 
difference. You should yourself see about the snugness of 
fit. 

In the case of the Gertrude suit, if you prefer the sup- 
porter, you can put supporting buttons upon the inner gar- 
ment of the suit. 



A Depressed Toe; Heels and Soles. 

When my three-year-old boy was born, we noticed that the toe 
next the big one on the left foot was inclined to turn under the next 
one. He wore chamois moccasins till a year and a half old, and then 
broad-toed shoes ; but I find the toe is not getting any better ; the 
big toe seems to push over and almost meets the third toe, leaving the 
second quite underneath. It does not seem to give him any pain 
now, but I fear will do so later — the nail seems to pass almost through 
t h>- flesh, 

Is there anything I can do for it ? We thought perhaps stockings 
with separate toes might bean advantage, but do not know if they 
are made for children — can you tell me? 



NURSERY PROBLEMS. 



Also, can you tell me where to get shoes without any heels ? He 
is wearing the largest size of infant's shoes and the next size has 
spring heels. I cannot see why, if shoes with no heels are best for 
little children, they are not always best ; and then they all have such 
thin soles. I have used cork soles in my boy's shoes all winter. 

Uniontoa-n, Pa. Inquirer. 



The toe may have had, probably did have, some eon- 
genital peculiarity. The management of such toes requires 
quite a little ingenuity often. The intrndiug, overlapping 
toe must be kept in place. Various devices have been used, 
and which particular one is best adapted to this case we 
cannot tell by description. Ofteu, too, after the depressed 
toe has occupied such a position for a time, it will be neces- 
sary to raise it by a strip of adhesive plaster or in some other 
way. You can do a good deal, but you will work best if you 
have the advice of some good physician of your neighbor- 
hood. Get that one who has the most surgical or mechani- 
cal "knack." The stockings with separate toes are usually 
knit to order we think. 

The "spring heel," meaning only a thickening of the 
sole at the back, is harmless. The essential reason, we ap- 
prehend, why no heels are used for any young children is to 
allow them as free movements of their feet as possible until 
they get control of them. They stumble and fall very 
readily at best. Any stiff sole would aggravate this ten- 
dency ; later, they can manage a stiffer sole, and the spring 
heel is only a slight additional protection to the sole of the 
foot. The thinness of the sole need not be prolonged after 
children have good use of their limbs, but you must not 
expect the shoemaker to make innovations unless loudly 
demanded. Shoes are made to sell, and the shoemaker is a 
merchant, not a physiologist, nor usually a philanthropist 



QUESTIONS OF DBESS. 



Stiff Soles for Babies. 

At what age should a child wear stiff-soled sboes? Our baby has 
worn kid shoes, soft soles, since he was seven months old. He is now 
one year but has never shown any inclination to walk or creep. He is 
large for his age, strong and healthy. "Will a stiff sole injure the 
shape of the foot? 
Newton, X. J. R. P. C. 

The stiff sole is not necessary until he begins to walk 
out-of-doors ; it then is useful to prevent bruising of the foot. 
The stiffness of the sole, if the shape is right, will not change 
the shape of the foot ; but unfortunately the shape of baby- 
shoes is not always right, although they are usually less 
atrocious than the soles made for adults. 



TRAVELING. 



Preparations for a Proposed Sea- Voyage. 
I. 

In September we are to take our baby boy, who will then be 
fifteen months old, to Buenos Ayres. He has been brought up on 
Mellin's Food and cow's milk since the age of four months, is strong 
and healthy, but is, we think, rather backward in cutting his teeth, as 
at nine months he had but one. 

Can you offer any suggestion that would be of help to us in re- 
gard to preparations for his long sea- voyage ? 
Jamaica Plain, Mass. H. W. 

II. 

As I am contemplating a journey across the ocean the early part 
of May and intend taking two young children, would you kindly ad- 
vise me what preparations I ought to make ? 

(1) What is the proper clothing required on the steamer, for a boy 
four and a half years old and a baby eighteen months old ? 

(2) Ts it best to be provided with medicines, and what should they 
be? 

(3) "What kind of milk shall I provide for the journey ? 

(4) Will a journey of this nature subject my children to any 
danger ? 

Detroit, Mich. A. S. 

I. 

There is nothing very definite to be said regarding an 
ocean voyage for an infant. While the belief some times 
held that infants are not seasick is not entirely true, it is 
nevertheless true that they usually bear the motion of the 
ship remarkably well, perhaps from the same immunity, 
whatever its cause, that makes them tolerate or even appa- 
rently enjoy tossings and turnings and positions which 



TRAVELING. 215 



would make an adult giddy. The comfort of an infant 
aboard ship depends very much upon the condition of its 
attendants ; if they can properly care for its needs (food, 
fresh ah, etc.), it is likely to do well. Food on ship-board 
need not be changed from land diet, If you wish to con- 
tinue your boy's special diet you can do so, but at fifteen 
months he will have probably outgrown it. He should be- 
fore the voyage be accustomed to a food very similar to that 
which you can obtain after you reach your destination. By 
laying in a supply of sterilized milk, or if you prefer, con- 
densed milk, you may face your voyage with little fear. 



II. 



(1) For the crossing, such clothing as would do for ordi- 
nary winter wear will probably be suitable. Early in May 
the weather on shore is subject to violent fluctuations — 
often a sbort season of high temperature being experienced 
— but at sea this is not likely to occur, and if it should come, 
the laying aside of heavy wraps will be sufficient. If the 
voyage be stormy, the children will probably be in bed. 
Warm woollen bed wrappers are a convenience if you are 
not too crowded for room. 

(2) The ship's surgeon will have all necessary medicines, 
but you may find it convenient to have a few simple ones, 
such as a laxative (constipation being common at sea) and 
remedies for colic and for nausea, such as peppermint and 
aromatic spirits of ammonia. 

(3) Sometimes steamships have an adequate supply of 
milk, but sterilized milk can be procured easily. It can, in 
New York, lie ordered sent on hoard ship, if you prefer, 
condensed milk can be taken. 

I There is no probability that your children will suffer 
more than temporary inconvenience from the voyage. 



NURSERY PROBLEM*. 



Diet During a Long Railroad Trip. 

i. 

May I ask your advice in regard to my baby, just a year old ? I 
have abundant breast milk for him, but as he has seven teeth, have 
thought it best to give him one meal of steamed oat-meal and milk. 
He is perfectly well. 

Next September, when he will be about eighteen months old, we 
expect to take him for a four days' railway journey. In consideration 
of that fact, (1) would you advise weaning him before September? 
(2) How often should he be fed? (3) At his age, is it necessary to 
have the milk warmed '.' (4) Would you suggest any extension in his 
bill of fare ? 
Madison, Wis. K. M. 

II. 

I am contemplating a three days' journey by rail with my twenty- 
months-old child in May or June, and shall be greatly obliged if you 
will advise me what to feed him during the time. I am very much 
concerned about it, as he is accustomed to warm food three times a day. 
Kansas City, Mo. B. N. 



(1) While a mother occasionally has milk enough for a 
child of twelve months, it is almost phenomenal if she 
really has enough for a child of eighteen months. The 
chances would be much in favor of the milk giving out in 
the summer. Of course there are exceptions, but we have 
to advise according t<> probabilities. 

We would have the child weaned before the hot weather, 
by June 1st if possible, beginning soon and doing it grad- 
ually. 

(2) After weaning, five or at most six meals are enough, 
one every three to four hours, according to size of meals. 
Something like this is feasible : 7 and 10 A. M., 1, 4, 7 and 
11 p. m., or 7, 10.30 a. m., 2, .5.30 and 11 p. M. The hours of 
naps may vary the meal times. 



TRAVELING. 217 



(3) Yes ; lukewarm milk we think much better until 
three years of age on an average. The milk should at any 
rate never be given in childhood really cold, i. e., as taken 
from a refrigerator or chilling room. 

(4) Not until autumn. Inasmuch as on the four days' 
railway journey you will probably need sterilized milk, you 
would better teach him the taste of it in advance. Or for 
those days a good quality of condensed milk might be used, 
in which case a similar preliminary teaching will be advan- 
tageous. 

II. 
Borden's condensed milk is good and generally safe food 
to use while traveling. You can procure boiling water at 
the stations where the train stops for refreshments, and 
sometimes from the porter while the cars are in motion. 
There are nursery-lamps Avith sauce-pan, kettle, etc., which 
can be packed in a hand-basket and set upon the sill of the 
car-window, if you cannot have a portable lunch-table ar- 
ranged for you by the porter. Almost every "through train" 
is provided with these. Mix the milk with boiling water, 
as directed in the printed label on the can. 



THE MOTHER. 



The Promotion of the Suckling Power. 

I have been so much interested in Dr. Allen's suggestive article 
on the "Laws of Maternity" and in the other contributions on similar 
subjects which he has at various times published, that I am tempted 
to ask you for advice in a kindred matter, though of a somewhat 
different nature — namely, as to where there is no lack of quantity 
but a doubt as to quality in the mother's milk. 

To make myself better understood, let me cite the case in question, 
of one who has nursed her two children successively, each a year, and 
has had an abundant supply, giving the child no additional food until 
the tenth month, when feeding was substituted — in order to facilitate 
weaning — at first once a day, and gradually more and more often, until 
in the twelfth month the breast was entirely withdrawn. Both babies 
were happy, contented children, sleeping well all night, and taking 
long day naps. The oldest, now three years, has had but one illness 
of any importance, occurring at eighteen months, in his second sum- 
mer, and caused by the nervous excitement incident upon cutting 
teeth. "With a temperature at 103° for a week, and refusing to eat, 
life being sustained by drops of Murdock's food and outward applica- 
tions of brandy and cream, his recovery and rapid rallying seemed to 
indicate a strong constitution. The baby of fourteen months records in 
his little life no illness but one cold of short duration. The mother 
has no organic troubles, and is apparently an entirely healthy woman, 
bearing and nursing her children with little drain upon her vital 
forces. 

Notwithstanding all these favorable signs, it has been suggested, 
by both physician and friends, that her milk was not good for the chil- 
dren, and that they did not thrive as it was thought they would if 
allowed to suckle an Irish or English woman ; even manufactured 
food, it was hinted, might be preferable. Their argument was drawn 
from the following facts : The little ones lacked color, one of them be- 
ing very pale ; their passages showed, at times, want of proper diges- 



THE MOTHER. 



tion ; they were of light weight, as the following table will show : At 
three mouths, respectively, 12 and 13% lbs.; six months, 17 and 16% 
lbs.; nine months, 19^ and 18 lbs.; one year, 20% and 18% lbs. ; 15 
and 1-t months, 21% and 20 lbs. 

It will be seen that the increase, in both cases, was no more rapid 
after feeding was begun. These three symptoms — pallor, signs of in- 
digestion and slow increase in weight — were, I think, the only ones 
urged as reasons for a change of diet. 

(1) Bearing in mind the fact of the children being happy, con- 
tented and good sleepers, do the symptoms seem to you sufficient to 
warrant — should the question again need to be decided — the employ- 
ment of a wet-nurse and the discarding of the God-sent nourishment? 

(2) Cannot medical skill suggest means by which the lacteal fluid 
can be altered and improved or rendered more digestible? 

In this case the test of litmus paper showed no acidity and the 
milk appeared of sufficient richness. 

(3) Are there any rules which should be observed by a nursing 
woman, other than to abstain from highly seasoned food, to exercise 
self-control and avoid over- fatigue? 

(4) Dr. Allen speaks of the nutrition required by "preponder- 
ance of brain and nervous system," and the consequent "failure in 
lactation." Should one from this infer, that while suckling her child 
a woman ought to indulge in no literary pursuits, and should keep the 
brain, as far as possible, quiet and inactive, that it may not draw upon 
the system for nourishment required in other parts of the body ? 

(5) Should also the fact that the mother while suckling, gained 
rather than lost, in flesh and color, be regarded as detrimental to the 
babe and a possible reason why the child was less rosy and fat than 
could be desired ? 

Most earnestly do I beg for all the information that can be given 
on this matter. The case for which 1 ask advice is not, I know, ex- 
ceptional. Many similar ones have been cited to me, and I believe 
many more American women would lie able to suckle their children, 
did they only receive at first, in their weakness, the proper encourage- 
ment, and afterward the advice and instruction needed to continue suc- 
Cessfully. Too often, when the milk is slow in coming, the young 
mother nervous and anxious, Baby hungry and crying, other food is 
given or a tret-nurse substituted, without due amount of patience or 
proper efforts to stimulate sluggish nature, and without attempting, 
by cheerful assurances of success, to assist, the mother in producing that 



220 XURSERY PROBLEMS. 



flow which, when once arrested, seems stopped forever. Surely this 
also is a subject for consideration ; and may it not be possible that the 
number and variety of manufactured foods for infants, together with 
the ease in procuring wet-nurses, have been in a measure detrimental 
to the present American mother? Our New England grandparents 
knew of no other way than to nurse their own children. There was 
no question of anything else. The " Foster Mother" had not been 
imported from the Old Country. The "only true substitute for 
mother's milk" was not advertised in every paper and placarded in 
public places. But be that as it may, and fully realizing the justice 
and importance of Dr. Allen's statements, I still have faith in the 
present American mothers. I believe if those about to become mothers 
were better informed with regard to their personal care, and if the 
much-needed advice and help were only given to all in time, most 
American mothers would again, as formerly, successfully suckle their 
young. And as one of them I look for assistance to you. 

L. O. S. 

The subject about which you inquire is a complex one, 
but we answer as well as we can your distinct questions. 

(1) As you state the case — perhaps unintentionally iu an 
ex parte manner — we do not see that the necessity of change 
of breast was made out. When we recommend the change 
to a wet-nurse the presumption is that we are to change to a 
very good one— a presumption, unfortunately, not always 
sound. In our own searches we sometimes succeed promptly, 
sometimes only after many trials, or even then indifferently. 

(2) Perhaps medical skill some day may; I ait beyond 
good and careful nutrition, with medication if distinctly 
needed, it has as yet little power in changing the character 
of the milk. If the poverty in quality or quantity of the 
milk is dependent upon remediable or recognizable defects 
in health or diet we can do a good deal ; if it is due to faults 
of constitution it is hard to correct the evil. 

(3) The rules cannot be made hard and fast for every 
one, but beyond the points you suggest, we should say the 
diet is to be ample without being burdensome either in bulk 



THE MOTHER. 221 



or in its demands on digestion. Food should be taken at not 
too long intervals — i. e., between the regular three meals 
light auxiliary meals may be inserted. In this way milk, 
chocolate and the like are useful. That the fat (cream) in 
milk is increased by the use of nitrogenous food seems to be 
well established. 

(4) We do not understand that the " preponderence of 
brain and nervous system," etc., means that this is active 
especially during the period of lactation ; but that it has ex- 
isted throughout all the life, or at least the developmental 
stage of the woman, and has rendered successful lactation 
an improbability from the start. A female born with this 
nervous preponderance and whose life till marriage has been 
calculated still further to exaggerate it, cannot expect, even 
with the best regimen during pregnancy and lactation, to 
counteract it, except in a small degree. We do not suppose 
that moderate mental activity hinders suckling. 

(5) We think not. A woman may grow fat during 
lactation by reason of fattening food (milk, etc.) taken to in- 
crease the flow of milk, and if the child is not as rosy or fat 
as desired, it is not in our opinion because the mother 
gained, but from some other cause. A woman may gain 
flesh and secrete poor milk, but the same woman probably 
would secrete no better milk if she had remained thin. It 
is a matter of common remark that fat persons (or animals) 
arc not the best milk givers, but the difficulty seems to be 
inherent and not due to any gain at the time of lactation. 



Sore Nipples. 
My baby is bottle-fed because of the suffering caused by sore 
nipples and two gathered breasts, the milk having been so transformed 
by my nervous terror from the pain that it nearly killed her. Do you 
know or can you safely recommend a cure for sore nipples? 

Brooklyn. K. M. s. 



222 N URSER Y PR OBL EM S. 

"Sure cures" rarely exist out of the realm of popular 
medicine. We have none to offer. But careful attention to 
the following details generally insures immunity or speedy 
cure. The usual causes of sore nipples are two. First, want 
of development of the nipple, which makes it difficult for 
the child to nurse without violent sucking ; a similar condi- 
tion results from flattening of the nipple from pressure by a 
corset for years, the nipple becoming broad, but not promi- 
nent enough for the lips to grasp it. The second cause is 
want of cleanliness — not want of ordinary cleanliness, but 
of absolute cleanliness, or, as the medical phrase is, " surgi- 
cal cleanliness." It may be said at the start that some per- 
sons — particularly persons subject to eczema — seem to have 
a greater tendency than others to these nipple troubles. 

When the nipple is not well developed or is flattened, 
much may be done during the later months of pregnancy to 
enlongate it by gently but persistently drawing it out and 
pressing backward at the same time the darkened skin 
around it (areola.) If at this time the surface of the nip- 
ple seems to be tender, it can often be hardened by fre- 
quent bathing with alcohol or with some astringent solution, 
such as alum-water, alcohol and alum, witch-hazel extract, 
and the like. Occasionally a person is found whose skin 
does not tolerate these applications, but in the great majority 
of cases they agree and are beneficial. But no preliminary 
preparation will be effectual if the details of toilet of the nip- 
ple, presently to be spoken of, are not heeded. 

Sore nipples are of two kinds, those that are tender or 
excoriated ("raw") arid those that are fissured or cracked. 
The prevention and much of the curative treatment is the 
same for both. The first kind are usually made tender first 
of all by the oozing of the watery liquid that precedes the 
milk. This, with the moisture of Baby's mouth and a little 
milk (when it has come) left after nursing, if not removed 



THE MOTHER. 223 



with the utmost care, will remain in the minute folds of the 
nipple-skin and soon set up an irritation. At first, to the 
naked eye, or even with a magnifying glass, nothing is evi- 
dent but a redness of the surface ; but this spot is exquisitely 
tender, and many women who have bravely borne the suf- 
fering of labor shrink from the putting of the baby to the 
breast. This, if not promptly attended to, becomes a raw 
surface, and even more tormenting than before. 

Xow, from the start the nipple should be kept scrupu- 
lously clean. It should be bathed before suckling and after 
it. Some mild and unirritating disinfectant should be used 
— boracic acid is our own preference — dissolved in the warm 
water employed for bathing the nipple. It will be worth 
while to examine the nipple, and particularly its base, for 
wrinkles and folds of the skin, because in these the ferment- 
ing liquids hide and set up the irritation. If such folds be 
found they may be washed out by the aid of a camel's-hair 
pencil. The parts should then be carefully dried, unless the 
attendant thinks it better to keep some soothing wash al- 
ways on the nipple in the intervals of nursing. One au- 
thority advises the use of Goulard 's extract — a teaspoonful 
to a tumbler of water— to be kept for several days on the 
nipple by means of a soft cloth, washing it carefully away 
before nursing. 

If but one nipple is sensitive the task is easier, for then 
the child may take the other for a day or two, the tender 
breast being carefully emptied by stroking and rubbing. 
Two days' rest of a nipple almost always results in a cure. 
When, however, both nipples are troublesome, they require 
more attention, but the rest of both breasts results in a dis- 
appearance of the milk altogether. 

The treatment of cracked nipples demands the same 
precautious as have been detailed. In addition the fissures 
themselves often, if not usually, need local treatment; but 



224 NURSERY PROBLEMS. 



as this can only be well carried out by the physician or a 
well-instructed nurse, it is not worth while to enter into it 
here. 



The Diet of a Nursing Mother. 

What should a mother eat while nursing her baby, or what especial 
things should she avoid eating ? 
Santa Rosa, Cal. W. M. G. 

No explicit directions can be given. There is a very 
general belief among mothers that their articles of food may 
affect the suckling's digestion. There is nothing improbable 
in this, since we know that some drugs taken by the mother 
can be recognized in the milk ; and certainly in cow's milk 
the taste of certain things, the turnip, for instance, eaten by 
the cows is often recognized. In practice, however, women 
are not harmonious in their opinions as to the kinds of food 
which do affect the suckling, and some medical men are 
skeptical as to the whole matter. For ourselves, we think 
the truth is about as follows: Any good wholesome food 
which the mother can ordinarily fully and easily digest, i. e., 
without distress, acidity, flatulence or other evident disturb- 
ance, may be eaten, with perhaps the exception of such 
articles, chiefly vegetables, which contain a strong volatile 
oil or principle such as we can recognize by the taste in 
cow's milk. Such are the cabbage, cauliflower, turnip, onion 
and garlic. Now, we are not quite sure that even all of these 
need in every case be avoided, for they certainly form a con- 
siderable part of the diet of nursing women in some walks 
of life. Whether in those cases they do not usually affect 
the infant, or whether a certain amount of disturbance of 
the baby's digestion is in those rather unintelligent circles 
considered as normal or unavoidable, we do not positively 



THE MOTHER. 



know. We should advise the use of other things in prefer- 
ence ; and in ease these vegetables are especially craved or 
are needed as laxatives, that they be taken cautiously and 
the effects noted. There are many articles which some per- 
sons digest perfectly and others only with the formation of 
much gas, notably starchy things — white bread, potatoes, 
beans, etc. Concerning such there is no rule beyond indi- 
vidual experience. It would be a pity to avoid any food that 
is wholesome to the mother if it is not really disturbing to 
the child. 

We believe that all alcoholic beverages should be used 
sparingly and with great circumspection, unless ordered by 
a physician, in which case explicit directions as to dose and 
the period during which they should be used should be 
asked for. 

The Best Method of Drying Up the Mother's 
Milk. 

What is the best method of drying up the mother's milk ? 
New Jersey. F. L. B. 

Ordinarily, absolutely nothing is needed but to let the 
breast alone. If the breast fills, stroke or pump out the 
milk. Belladonna ointment applied to the breast, however, 
hastens the disappearance of the milk and eases pain, but 
do not let the infant get any of the ointment in its mouth 
or eyes. It is very poisonous. 

Care of the Mother Rather than the Child. 

My baby boy is two weeks and one day old, and is, to all appear- 
ances, a healthy, hearty little fellow ; he weighed over twelve pounds 
when born and has gained about half a pound since. He sleeps from 
four to seven hours at a time, and has twice in his short life slept from 
eleven in the evening until seven next morning without waking to be 
nursed. I don't believe he has cried an hour altogether since he came 
into the world. He has never had the slightest symptoms of colic. 



X I L'SKH Y PROBLEMS. 



The one trouble seems to be with his bowels, as he has had not a 
digested passage since his birth. My physician has tried several 
different remedies without apparent effect ; he has analyzed my milk 
and pronounced it satisfactory in quality and sufficient in quantity. Is 
this trouble likely to wear away, or will it, as I fear, result in loss of 
flesh and strength to the child if allowed to continue ? I am perfectly 
well myself, and am rapidly regaining my strength. 

Yonkers, N. Y. G. M. 

A baby of fifteen days, who is as comfortable, in 
spite of the imperfect digestion of his food, as the one de- 
scribed does not seem to us to need much mediciue. It 
seems, however, that his mother needs some caution. Few 
mothers are allowed to write letters fifteen days after de- 
livery, and we fear that this forwardness may be evidence of 
premature resumption of other more taxing duties. We 
would advise care on the mother's part and the continuance 
of the physician's supervision both of mother and child for 
some time longer. 



"Nursing Sore Mouth." 

Can you give a cure for "nursing sore mouth'";' If not, please 
give such advice as you can and greatly oblige 

X T ew Bedford, Mass. A Sufferer. 

The disease known as "nursing sore mouth" is, fortu- 
nately, a rare one nowadays. Some thirty years ago it ex- 
cited much discussion in American medical journals in vari- 
ous parts of the country. It has been known to be epidemic 
where some bad climatic or hygienic conditions have ex- 
isted. The disease is probably always dependent upon 
ansemia (thin blood), and it sometimes occurs before de- 
livery, and has even attacked males. Authorities agree that 
the surest cure lies in tonics, iron, quinine, cod-liver oil, 



THE MOTHER. 227 



good food, and perhaps wine. One writer goes so far as to 
maintain that it is neither more nor less than scurvy. The 
best preventives are good, generous diet and good hygiene 
during pregnancy, as well as during the nursing period. 



Excess of Abdominal Fat. 

Is there any safe and practical way of removing superfluous fat 
from the abdomen ? The nurses here never bandage after labor. 
Would that account for it ? Immediately after the birth of each of my 
two children there has seemed to be no adipose tissue there at all. 
Before I am out of bed, however, it has begun to be deposited all over 
the surface of the abdomen, and, alas ! it continues to come. My 
general health is good. I take much out-door exercise, and my diet is 
mainly meat and fruits, as I do not care for sweets or starchy foods of 
any kind, but the melancholy fact remains and I fear the trouble will 
increase — 28 inches waist, 48 inches hip ! I know this question has 
nothing whatever to do with the care of babies, but as the trouble 
seemed to be caused in some indirect way by them, I take the liberty 
of coming to you for help. 

Tennessee. O. S. B. 

The excess of abdominal fat after delivery is not de- 
pendent upon the absence of the bandage. We have often 
seen it occur just the same with the bandage. The peculiar- 
ity is in part constitutional. For its relief, diet will do 
something, kinds of food and amount of liquid both being 
considered. But during lactation, a good deal of liquid may 
be needed. Further, we believe that systematic muscular 
exercise of the abdominal wall is useful, in that much of the 
protuberance of tbe abdomen is due not to the fat but to the 
laxness of the muscles. We have knowledge of instances 
in which during a course of exercise several inches were lost 
in girth while no weighl was lost. Even if girth be not re- 
duced, the muscular gain enables one to be more active. 



228 NURSERY PROBLEMS. 

Hair Falling Out After Confinement. 

In behalf of some of my friends as well as myself, I want to know 
if you can give me any information regarding the prevention of the 
falling out of hair after confinement? I have very heavy hair, but 
after the birth of my little boy, two years ago, I lost fully one-fourth 
of it, and it has not grown in to any length since then. Now, a fre- 
quent recurrence of this would be most disheartening. Is there any 
known treatment of the scalp, either before or after confinement, that 
could prevent this? 
Des Moines, Iowa. F. C. M. 

We know of no way of preventing this peculiar fall of 
the hair, which is of very common occurrence and very 
similar to that following severe illness, particularly if at- 
tended with fever. Fortunately the hair usually returns as 
fully as before ; but as a very long time — many months or 
even some years— is required for it to gain the great length 
seen on some women, the frequent recurrence of pregnancy 
might prevent its reaching its original length. Applications 
to the scalp are useful if there is a recognized disease of the 
scalp ; but in cases where there seemed to be no local disease 
we have not been able to see that the growth of the hair 
was more rapid after using the most approved local applica- 
tions than in those instances in which none were used. 



MISCELLANEOUS. 



A "Hard-Reared" Baby. 

My baby has attained the age of sixteen months. He has been 
unavoidably bottle-fed, and has been what many would call a "hard- 
reared baby," but now seems perfectly healthy and fairly developed, 
walking but not talking, and boasting the possession often teeth. His 
diet is still confined, of course, to milk, cream, oatmeal, an occasional 
fresh egg, roast potato and bread and butter, of which last he is inordi- 
nately fond. 

So far so good. But Baby has one or two bad habits that seem to 
grow with his growth — first, exceeding restlessness at night ; second, 
there seems to be an impossibility of weaning him of night feeding, or 
drinking rather. 

He has never, I believe, slept a night continuousW, whatever his 
state of health. Just now his programme is to wake once, say about 
2 a. m., scream violently for a few minutes, and insist on having some 
one take him from his crib to amuse and pacify him, and finally, after 
about half an hour's recreation, he condescends to accept a full bottle 
and retires with his treasure. Frequently he drinks two or three 
bottles of milk through the night, although in the day he never looks 
for one, drinking from a glass or cup at meal-times. 

I am quite at my wits' ends. What am I to do ? If I let him 
cry on without heed or help, it seems to me he will certainly cry him- 
self to sickness, so violently does he set about it ; and how can I wean 
him from drinking ? 

Philadelphia. M. M. H . 

We will tfive w hat help we can on the facts stated. The 
phrase "hard-reared " we interpret to mean that his rearing 
was difficult, either from distinct sicknesses or from some 
delicacy or feebleness ; if the latter, most probably digestive 
derangements. He now, at sixteen months, lias ten teeth, 
probably the eight incisors and two of the first molars. 



230 NURSERY PROBLEMS. 

His "two bad habits" may be considered as manifesta- 
tions of one. To give the cause of them, of course one 
should know a great many things not stated in the query. 
But one cause is suggested by the facts given. A child with 
probably only two molars has among its articles of diet two 
things notably hard of digestion at his age, and only di- 
gestible after prolonged chewing — namely, potato and bread. 
Both of them contain starch in a very large proportion. 
Fine wheat flour contains, according to some analyses, up- 
wards of 70 per cent, of starch, and bread from it still near 
50 per cent., some of the starch having been changed by the 
raising and cooking of the bread. Raw potato has, say, 92 
per cent, of starch. Now, without claiming, as some seem 
inclined to do, that starch is the great poison of infancy, it 
cannot be denied that it is very indigestible to children. 
Only prolonged chewing makes its digestion probable in 
adult life, and to many people it is always indigestible. To 
an infant as yet uusupplied with chewing-teeth (molars) it 
must be very difficult of digestion. The form of indigestion 
need not be one that must cause immediate pain, or per- 
haps any great pain at all, but it may lead to derangements 
of a remoter kind. This may not be the case with your child, 
but we cannot help associating the starch and the restless- 
ness. 

The demand for the "full bottle" is probably a natural 
sequence of the other troubles, or it may be partly habit — 
we cannot speak with precision for want of information. 
We presume you have tried water to make sure it is not 
thirst that troubles the child. If you have not, try if a bot- 
tle of water, not too cold, will not content him. Many chil- 
dren, however, demand the bottle because they have been 
taught all their short lives to expect something to be put 
into their mouths as the preliminary to sleep. They do not 
need food any more than many men need spirits, but they 



MISCELLANEOUS. 231 



have gained a habit. If we had to deal with a wakeful or 
restless child, and could find out only the things you have 
stated, we should first get rid of the starch, giving in place 
of the rnilk diet for one meal some beef-juice or good plain 
broth (bouillon) of beef or mutton. If he craved bread he 
should bave only the hard crust, which is more digestible 
than the soft crumb and portions of which cannot be swal- 
lowed until it has been diligently chewed off from the piece. 
The details of the remaining management would depend 
upon the success attending the change of diet. It is well, 
however, in the case of any "hard-reared" child, to have 
occasional advice from your physician, who can work out all 
the real facts. What has been said above is based on the 
few placed before us. 



The Flow of Milk the First Days After Delivery. 

Will you please tell what is best to be done the two dreadful days 
afterbirth, "before the milk comes"? If there is to be none, would 
it not be as well to feed the child at once ? "Why is there such a 
break in an infant's nourishment? 

San Francisco. E. "W. 

Those days are not always "dreadful " ; indeed, we think 
they rarely are so in this day of good nursing. That the ab- 
sence of the milk is not a detriment to the baby may be in- 
ferred from the fact that most living things in nature are 
adapted to their surroundings, and also from the following 
lads. Not only infants but all young mammals pause in 
their growth for a few days, perhaps for a week, after their 
birth, and they may absolutely lose weight. A similar de- 
lay is noticed in newly-hatched chickens, which, of course, 
never depend upon tbe mother for food. The experiment 
has been tried, in a series of cases, of putting new-born in- 
fant.-- io the breasts of women who had been delivered a few 



N URi>ER Y PR OB LEMS. 



days previously and who.se flow of milk was established. 
These children all lost weight like others. The cause of this 
loss is not certainly known, but is believed to be due to the 
fact of the establishment of respiration and the necessity of 
the child's furnishing its own heat instead of getting it from 
its mother. More tissue is burned up until the new order is 
established. If during those days the child is kept warm 
and its thirst quenched with warm liquid, it generally 
makes little complaint. 



Thumb-Sucking. 

In your personal observation, have you ever seen children whose 
teeth projected, or whose upper jaws were Y-shaped, because of hav- 
ing sucked their thumbs? 

Pulaski. X. Y. L T. G. 

We have often seen -the V-shaped jaw in children who 
were thumb-suckers. It is reasonable to suppose that the 
habit was the cause, although it would be impossible to 
prove that the jaw might not have had this shape had the 
child not sucked its thumb, because such shaped jaws be- 
long to some families, and no one can recollect whether or 
not the elders were also thumb-suckers. Further, we have 
seen other and more complicated distortions of the upper 
jaw, and even of the nose, caused by the pressure of thumb- 
sucking, which it required much trouble on the part of the 
dentist, and expense on the part of the parents, to correct. 
Those who have given most study to the matter (scientific 
dentists), whose opinions we know either by reading or con- 
versation, agree in considering thumb-sucking a potent if 
not the main cause of the V-shaped jaw. 



MISCELLANEOUS. 233 



Popular Misconception of Medical Terms. 

Is there any difference between diphtheria and membranous 
croup, and is the latter contagious ? And is it only allopathic physi- 
cians who consider them identical ? 

Covington, Ky. J. V. S. 

We may say at starting that so far as we know there 
never was any school of physicians calling themselves allo- 
pathic or allopaths. But by a singular misuse of words the 
name is popularly applied to those who do not accept the 
doctrines of homoeopathy or any other pathy. The special 
point asked about has never to our knowledge been made a 
distinctive one between any schools of medicine. 

The identity of diphtheria and membranous croup has 
been very much discussed for many years, and the opinion 
has varied very much with time. Physicians who were in 
practice about thirty-five years ago, the time that diphtheria 
first reappeared in this country after a very long absence, 
pretty generally considered it as a very different disease 
from the then well-known membranous croup. As time 
has passed, this opinion has lost ground, and has nearly dis- 
appeared. We doubt if the question can be absolutely de- 
cided. But without any intention or desire to dogmatize, 
we may say that our own notion is this : That the mem- 
branous croup of forty years ago was not diphtheritic ; it 
was rather a rare disease as compared with diphtheria to- 
day, and the evidence of its contagiousness was wanting. 
On the other hand, to-day a membranous laryngitis (croup) 
is practically always diphtheritic, the change probably being 
due to the general diffusion of the diphtheria poison. There 
arc many kinds of sore throat characterized by a membrane- 
like exudation, concerning the nature of which agooddeal 
of doubl and difference of opinion exists among those well 
qualified to judge. Thus there are many cases which every 
one agrees to be diphtheria ; other cases every one is equally 



234 NURSERY PROBLEMS. 

sure to be non-diphtheritic ; but between are many kinds of 
tonsilitis concerning which a guarded opinion must be 
given, unless one take the short and easy method of classing 
them all together as diphtheria, a method which tends to 
magnify the repute of the user, as a vast majority of his 
cases will get well. 

We may mention one term only to condemn it : It is 
"diphtheritic sore throat." If any disease is diphtheritic it 
is diphtheria: if it is not diphtheria it is not diphtheritic. 
If the physician is not sure of its nature he should have the 
courage and honesty to say so, and not hide behind a tricky 
phrase. The danger of using it lies in the habit of people 
to be misled by a meaningless name, and neglect necessary 
precautions. Every doubtful case of throat disease should 
be treated as dangerous. 

In leaving the subject, we may mention a similar dan- 
gerous blunder in the supposition that scarlatina is a mild or 
innocuous form of scarlet fever. Scarlatina is simply the 
Latinized technical name for scarlet fever ; the blunder 
probably arises from mistaking the termination "ina" for a 
diminutive. Scarlatina is neither more nor less than scarlet 
lever. 



Number of Movements of Bowels a Day. 

My baby is nearly ten weeks old, weighs twelve pounds, and 
seems comfortable and thriving, sleeping on an average fifteen hours 
out of the twenty-four, so I suppose he is doing well. 

I want to ask how many movements a day a healthy child of his 
age may have. He always has five or six, and sometimes eight, in the 
twenty-four hours, which seemed to me too many. They are for the 
most part a good color, though once in a while what he passes will be 
very green ; the consistency is all right. We feed him with cow's 
milk, prepared with " Peptogenic Milk Powder," fixing it in the 



MISCELLANEOUS. 235 



morning for all day and night according to direction " No. 2," which 

only directs the milk to be " scalded" after standing in the "bath." 

Bloomfleld, &. J. H. M. B. 

The usual number is from three to five. But an in- 
creased frequency above this standard, if the stools are of 
proper character, is not a sign of disease. If the movements 
are right in color aud properly digested the over-frequency 
may be disregarded. 



Ambidexterity. 

My boy of twenty-six months uses both hands alike, and has no 
difficulty nor awkwardness with the left. Until he is able to eat at 
the table, feeding himself, I shall make no distinction. Am I not 
right? At table, of course, he should not be singular in the use of 
knife, fork, or spoon, but I believe in all else he should be able to 
command one hand as well as the other. 

Brooklyn. R. M. S. 

The question of ambidexterity is a very interesting one. 
If a person can use both hands alike, or nearly so, he has a 
great advantage over others. By no means discourage the 
use of both hands. But examine if he has real ambidex- 
terity, or whether he is left-handed. A left-handed person 
is usually easily taught to use his right hand, but he is 
likely always to resort to his left hand for any effort of 
strength. It has been urged that all children should be 
taugbt to use both hands alike, but practically it is impos- 
sible, for scientific inquiry has shown that in proportion as 
races or people are cultivated theleft-handedness disappears. 
No people is known in which left-haudedness predominates, 
but some tribes exist in which, if our memory serves us 
rightly, as many as one-third of the individuals are left- 
handed — at least three times as large a proportion as among 



N URSER Y PR OB L EMS. 



Europeans or Americans. And this predominant right- 
handedness is not the result of education, but of heredity, as 
mo?t children require very little teaching to make them use 
the right hand, and a great deal to use the left. The child 
that shows ambidexterity should be encouraged in it, and if 
you wish your boy to have certain table manners teach him 
only at table. Do not make him ashamed of his left hand. 



Excessive Perspiration. 

Will you be kind enough to tell me whether excessive perspiration 
in a child is weakening ? My baby, now nine mouths old, is perfectly 
healthy, weighing twenty-four pounds. She has four teeth, and 
sleeps and eats well, having six meals in the twenty-four hours. She 
is fed on groats almost entirely, and was partly nursed and partly fed 
until last month. She has never been sick, although she has been 
troubled with eczema since she began to teethe, but this has now near- 
ly disappeared. She perspires principally in her neck and the back of 
her head, and cannot bear more covering at night than a sheet, even 
when it is cool. We found a feather pillow too heating, and tried a 
hair one ; now we are obliged to lay a linen sheet, folded many times, 
under her head, and, although this is saturated, it is the only thing 
that keeps her tolerably cool when asleep. I should like very much to 
know if this perspiring is healthy, as many people tell me, and if 
checking such a thing suddenly would not be likely to bring back 
eczema. 
Boston. T. G. 

The description given is an excellent one of the perspi- 
ration of early rickets. The child should at once be brought 
to the notice of the family physician, or, in his absence, of 
a physician familiar with children's disease*. In spite of 
Baby's fat condition there is pretty certainly a fault in her 
nutrition. 



MISCELLANEO US. 



The Infant's Normal Weight. 

How much ought the normal child to gain in one week ? What 
is an average or fair weight for a child of four months ? 
Newington, Conn. K. M. F. 

Growth varies greatly according to age. During the 
first week there is usually a slight loss, which loss is really 
made in the first three days. After this is overcome the 
gain is continual but not uniform. It varies first of all with 
different children, depending somewhat, but not entirely, 
upon the original size and strength of the child. A quarter 
of a pound per week is a fair gain for the first month or two, 
but the gain often reaches half a pound weekly for this period. 
By the age of four months it is slackening, being usually 
not much above a quarter of a pound per week. The weight 
at that age will be on an average about 12 pounds, sometimes 
14 or more, but the weight at four months, owing to the 
progressive retardation of growth, is on the average fully 
half what it will be at one year. Thus a child who weighs 
14 pounds at four months, cannot be expected to weigh 
above 25 pounds at twelve months, if so much ; and the 
weight at one year will not on the average be again doubled 
before the eighth year is reached. 



Drowsiness Following a Bump on tne Head. 

"What should I do when a child falls on the back of his head? 
Should I let him sleep or keep him awake ? My little boy fell from 
his high-chair a short time ago, hitting the back of his head with 
such force as to cause him to vomit. I was advised to let him go to 
sleep and send for a doctor, which I did ; but Baby woke up after an 
hour's sleep, quite bright. My physician says I should have kept 
him awake, but I think I did right. 
San Francisco. K. K. B. 



238 NURSERY PROBLEMS. 

We also think you did right. We do not know of any 
condition due to an injury where keeping the child awake 
can do any good, whereas sleep is often a restorative, as in 
the case of your child. If a child has taken a narcotic 
poison, such as a preparation of opium for a typical instance, 
the tendency to sleep much should be combated until the 
effects of the drug are past. In such a case as you are de- 
scribing, however, this condition is one of very mild con- 
cussion of the brain. Vomiting generally announces the 
beginning of reaction. The notion that children who have 
had a fall and have bumped the head severely should not be 
allowed to sleep is very common in popular medicine, but 
we do not remember to have met it in medical circles. It 
probably arose from a confusion of the stupor of compression 
of the brain, or of the symptoms of the meningitis which 
sometimes follows severe injuries to the head, with the re- 
storative sleep. 



Punishment for a Disobedient Child. 

My little girl of four-and-a-half is a nervous, rather precocious 
child, and I find it difficult to know how best to punish her when she 
is naughty. She is very disobedient, though I have made efforts ever 
since she was born to teach her obedience. Rather than give up her 
own way, she will disobey without the slightest hesitation, though she 
is quite well aware of the consequences. Can you suggest any mode 
of teaching her obedience? 
Montreal. M. D. L. 

There is little in the way of advice of a specific nature 
that we can give. We believe that the method of governing 
must be planned for each child. Careful and loving study 
of the child's character is an essential to success, and the 
particular way in which the child is to be managed is to be 
the outgrowth of such study. A parent should bear in 



MIS CELLARED US. 



mind that obedience is not an end in itself ; it is simply a 
means to the good of the governed. Military discipline is 
not for the benefit of the commander, but to make the army, 
in its time of need, the most powerful possible expression of 
the strength of the nation to which it belongs. Domestic dis- 
cipline exists only for the general good, and is gradually re- 
laxed as the development of childish intelligence enables the 
child to appreciate its responsibilities and to govern itself. 
Parents often forget this. The wise parent will avoid unneces- 
sary collisions of will between herself and the child ; but if a 
collision is inevitable, she must not leave it doubtful who 
has been victorious. All of this frequently involves in- 
effable patience, self-control, and often self-abnegation. But 
it has its reward. Every child, not absolutely mentally or 
morally hopeless from defect of birth, will show the effect 
of such care. Not all children can reach the same moral 
any more than the same intellectual plaue, but all are 
helped by kind and conscientious care, even if the child be 
cleverer by nature than the care-taker. The methods of 
guiding may vary greatly, but unnecessary crossing of a 
child's purpose is one of the poorest. 



The Selection of a Wet-Nurse. 

I have read with great interest Mrs. "NV.'s communication con- 
cerning wet-nurses in the columns of Babyhood. Doubtless the 
evils and dangers of entrusting one's delicate child to a stranger are 
great ; but, after all, in many cases they must be bravely met in order 
to save the very life of the child. Artificial nourishment is at best 
only a makeshift. I tried it once, in the case of my second child, but 
determined never to bring up another child on the bottle as long as I 
was able to pay for a wet-nurse and bear up physically with the in- 
evitable annoyances in her train. But not many mothers can bespeak 
a wet-nurse in advance, and in the hurry of procuring one in the hour 






NURSERY PROBLEMS. 



of need it is almost impossible to exercise the care and discretion that 
are so essential in the selection of the proper person. Nor is a physi- 
cian's advice always available. I have often wished to be informed 
concerning the physical qualifications of a wet-nurse, but have never 
found anything really useful in popular books or periodicals. It 
would seem superfluous to look for even average mental or moral 
qualifications in persons of the class that furnish wet-nurses, and I 
know that many excellent persons object to employing them under any 
circumstances whatever. But those who do employ them need en- 
lightenment. Perhaps you could furnish what I have vainly looked 
for elsewhere. 
San Francisco. L. J. 

It hardly need be said that few people yearn for the ad- 
vent of a wet-nurse in the family. Nevertheless there is no 
manner of doubt that the experience of most of those who 
have tried both the wet-nurse and the artificial feeding coin- 
cides rather with yours than with that of Mrs. W. She had 
exceptional ill-luck, aud moreover, as appears from her let- 
ter, she began with an intense aversion for a nurse, and, as a 
result, did not fail to have the difficulties in getting on that 
always attend aversions. A medical man of experience once 
said in our hearing: "A wet-nurse is a nuisance, but no 
one who has tried one will ever take any other way of bring- 
ing up a baby that she cannot suckle herself." And this is 
not far from the truth. 

Before speaking of the qualifications of a wet-nurse, a 
word ought to be said as to the duty of the mother who is 
obliged to give up the suckling of her own child. It has 
been in effect said by another that any one who takes the re- 
sponsibility of bearing a child is bound to furnish its food 
from her own breast, or to superintend herself the feeding of 
it if she cannot nurse it. Exceptions will occur, as when 
the mother's health absolutely disables her ; but the rule 
will stand. It would seem as if this would need no insist- 
ance, but it is a matter of daily observation that there are 



MISCELLANEOUS. 



raauy mothers who will hardly trust the house-maid to dust 
the bric-a-brac, who insist on personally laying out the 
changes of bed-linen and dispensing the groceries, and yet 
who never think of inspecting, except perhaps at rare inter- 
vals, the method in which the baby's food is prepared. 

Now, if a wet-nurse is procured a similar supervision 
should be exercised as over the dry-nurse. As wet-nurses 
are not selected from the highly intelligent classes, it is not 
to be expected that they will be very handy and tactful with 
a baby without experience ; and an experienced wet-nurse 
is not usually desirable, inasmuch as young women have, as 
as a rule, the best breasts, and experience and youth do not 
go together. The mother must do the watching, and re- 
member that the nurse has been chosen for the one physical 
quality of a good breast of milk. If she is not handy with 
the baby she is usually very glad to learn if she is kindly 
taught. 

A common complaint is that wet-nurses are tyrannical, 
demanding stimulants and various luxuries for the sake of 
the milk, and threatening to desert the baby if their de- 
mands are not granted. Occasionally a distinctly vicious 
woman goes out as a wet-nurse, but as a rule they are neither 
better nor worse than other women in their rank in life, and 
come with an honest intent to do their duty. If they prove 
to be tyrants it is because of want of sense on the part of 
their employers. In engaging a wet-nurse, she should be 
made to feel, if possible, that she has an interest in common 
with her employer ; that the employer is desirous of doing 
what is best for her health and comfort, because by so doing 
the welfare of the child is best secured. Moreover, she 
should understand that it is for her interest faithfully to at- 
tend to her duties; that no trifling with her own digestion 
and health will be tolerated ; and that, while she will be 
valued in proportion as the child thrives, she will not be 



242 N URSER Y PR OBLEMS. 

kept for a day if she neglects its interests. Let her under- 
stand that, while you desire breast-milk if it is good, you 
much prefer artificial feeding to poor breast-milk. If these 
things are clearly and kindly impressed upon her there is 
little probability of her playing false. The other method, 
too often seen, is to make a sort of pet of the wet-nurse for a 
while, to foolishly coddle her in all ways, until she is per- 
suaded that she is indispensable ; and then, unless she is a 
person of unusual judgment, she is spoiled, and the em- 
ployer reaps the harvest of her own folly, and considers the 
nurse a most ungrateful, if not an inhuman, creature. 

The choice of a wet-nurse should not be made without a 
careful medical examination ; the risk is too great. The em- 
ployer may ascertain points as to the character of the nurse, 
and may perhaps get information regarding her previous 
health and the health of her child or children. But after 
all the burden of the examination is medical, and cannot be 
properly assumed without professional knowledge. And for 
the physician it is an unenviable office. Not only must he 
find out the condition of the breast and the supply of milk 
and its probable continuance, but he must search with the 
greatest care for diseases or defects. And in this search he is 
never helped by the person examined ; she usually has no 
knowledge of the meaning of symptoms, and many things 
which the examiner would consider fatal objections she lays 
no stress upon. If she has knowledge of defects, in her de- 
sire for employment she would not obtrude them. The de- 
tails of the medical examination it would be useless to give 
here. The physician also endeavors to distinguish between 
the appearances due to ill-health and those due to poverty, 
want, and perhaps even hunger, or to distress at the pros- 
pect before the nurse of leaving her own child, for which 
she — and often with good reason — fears the worst. 



MIS C ELLA NEO US. 



Psoriasis. 

"Will you kindly give me some information regarding psoriasis in 
young children? My little girl, six years old, who is perfectly 
healthy in every other respect, has been disfigured with this disease for 
more than three years. 

(1) Can the disease be entirely eradicated, and, if so, how long is 
it likely to take ? 

(2) Is there any particular period of life when it can be most 
favorably treated ? 

(3) What effect have eruptive fevers, such as chicken-pox and 
measles, on the disease? 

Toronto, Canada. G. B,. 

(1) As relapses of psoriasis are very common, and as the 
eruption varies at different times in the course of a year, dis- 
appearing and reappearing, it is not easy to say how often a 
permanent cure is effected. The particular attack may be 
cured, but the tendency to return may still be present. For 
this reason no specific answer can be given to the question 
as to duration of treatment. But this much can be safely 
said, that some cases remain cured for as long a time as the 
physician is able to follow them, and that the treatmeut may 
require only a few weeks, or may be very tedious. 

(3) It should be treated as promptly as possible, and, as 
age does not seem to materially influence its appearance, it 
cannot be said to influence the time at which treatment will 
be particularly efficient. 

(3) Probably no permanent effect. One eruption will 
complicate the other temporarily. 



Intermittent Fever. 

Can you tell me what is the matter with my little girl? She is 
two-and-a-half years old, and large and strong for her :u<'. 

On several occasions she has complained early in the afternoon of 
feeling very tired and has wanted to lie down ; she has then become 



244 NURSERY PROBLEMS. 

very sleepy and flushed, and has nearly got into a kind of stupor, 
lying with her head and face almost buried in her pillow, and with 
her knees drawn up to her chest ; this is accompanied with fever, and 
every now and then she has been sick at her stomach, and has then 
fallen off again into the same state, from which no noise will rouse her; 
towards night she gets cooler, and in the morning wakes up much 
better and quite bright, but still a little flushed and feverish. She 
has had these attacks three times ; the second time it lasted a week, 
and every day was nearly a repetition of the previous one ; the last 
attack lasted about two or three days. 

I have had doctors' advice, but with apparently little result, and 
I should like to know what is really the matter, as I fear a recurrence 
of the attack. I feed the child on meat only every second day, and 
only give a little of it to her with potato ; her other diet consists of 
bread and milk and bread and butter, with light puddings, and noth- 
ing else. The strange part of the attack is this repetition of the fever 
and sickness at the same hour each day, and the apparent entire relief 
from it in the morning. 
Montreal. A. S. 

The stupor and other symptoms doubtless depend upon 
the rise of temperature. This may be due to a multitude of 
causes. But the distinct periodicity of the attack would 
make the diagnosis of intermittent fever a very probable 
one ; although with children we are very shy of using the 
words "intermittent," "remittent," or "malarial," as they 
are made the cloak of a world of ignorance. Intermittent 
fever is the most distinct of malarial disorders. In a typical 
case in an adult the chill which announces a paroxysm 
occurs with considerable regularity — daily, on alternate 
days, or less often, according to the variety of the fever. A 
fever with a daily access is called a quotidian ague ; one with 
an access on alternate days is a tertian ague, and so on. But 
in childhood the frank chill is less common, and the fever is 
less regular than in adults. And herein lies the danger of 
error, since in most diseases of childhood the temperature is 
more subject to fluctuations than in adults. An irregular or 



MISCELLANEOUS. 245 

paroxysmal fever may arise from a multitude of causes and 
may be — indeed, often is — classed as " malarial" or "remit- 
tent" simply from the temperature range, while the mala- 
rial poison has nothing whatever to do with it, and the real 
cause behind the fever may be overlooked and its treatment 
therefore neglected. Many physicians do not in a doubtful 
case make a diagnosis of malarial disease until they have 
after proper search failed to find any other reasonable cause. 
Fortunately, the true malarial fevers are usually quite 
amenable to medical treatment. 



Sleeping Breast Downward. 

I am in trouble regarding the position my babe takes in her sleep. 
She is a very nervous, excitable child, and, until she was six weeks 
old, seemed never to take any long, refreshing sleeps. She would 
sometimes refuse to take a single nap during the day, and even then 
was very wakeful at night. 

One day in desperation I turned her upon her face when I put her 
down for her nap, when, to my pleasure, she slept for four long hours, 
and she has refused ever since to sleep in any other position. She is 
now between six and seven months old, has always been well and 
strong, weighed at six months seventeen and a half pounds, and is 
naturally nourished. 

Many experienced mothers come in, see her lying upon her 
stomach, indulge in a rapid retrospection, which reminds them that 
their children never slept in this position, shake their heads omi- 
nously, and assure me that harm will come of it. One says it will 
flatten her nose, that she will "all grow to stomach," and her papa 
feels sure that her arms have a tendency to turn backwards in an 
awkward manner. 

For many reasons 1 think the position a good one, for she is much 
more easily tucked in her little bed, and never throws off the covers 
with her nervous little hands. She bobs her head from one side to an- 
other like a pendulum, only less often, and thus prevents its growing 
one-sided. She uses no pillow and seems to be very straight. 

Now, if there is any danger of her being injured in any way by 
this manner of sleeping, of course she must be broken of it, "though 



246 NURSERY PROBLEMS 

the skies fall " ; but if there is not I would like to leave her comfort 
unmolested. She is never rocked to sleep, indeed does not know what 
it means ; for once or twice, when I have tried to rock her to sleep when 
callers were in and I could not treat her in the usual way, she took it 
as a great joke, and seemed to think I was making a great effort to en- 
tertain her (though it took four weeks of bitter trial, yes, six, after the 
nurse left us, to teach her this element of virtue). You are to under- 
stand that she always sleeps upon her face, night and day, and if put 
down in any other way immediately opens her eyes and laughs at the 
folly of it. 

I am exceedingly anxious to be instructed in this matter, since I 
have thus far failed to see any bad results, though often assured that 
they would appear. 
Silver Cliff, Col. E. D. C. 
We have seen many infants and children, and some 
adults, who had this habit of sleeping on the stomach, and 
have never known any harm to come from it. Provided 
they do not bury their faces in the pillows in a way to pre- 
vent their having sufficient air, we do not know what harm 
is likely to result. It is easy to see why sleeping upon the 
side is easier to most of us than in any other position, but if 
a child is more comfortable lying on the breast and abdomen 
we should let it alone. The observation of habits of the do- 
mestic animals would reassure you. If you have a house- 
dog, notice how he will sleep upon his side or flat down upon 
his stomach with his head upon his forepaws. The cat will 
sleep in any position, side, stomach, or back, and all with- 
out any damage. 

Perspiring Feet. 

My little girl, aged four, perfectly healthy apparently, has each 
night her stockings and shoes damp with perspiration. I am sure it 
cannot be because her feet are too warm, for our home is in the country 
and the floors are not over- warm. Can you suggest the cause and cure? 
Though she never complains, it would seem as if her feet must be cold 
from the dampness. 
Newtown, Conn. M. B. 



MISCELLANEOUS. 



Perspiration of the feet is sometimes a personal peculi- 
arity, the cause ot which is not easy to discover, or is prac- 
tically impossible to remove. But as a common cause is an 
imperfect circulation, it is always well to search for anything 
that may retard the flow of blood from the feet. See if the 
stockings and shoes are wide and easy ; if there is any un- 
due tightness at the knee, etc. Watch if the palms also 
perspire when covered by mittens ; if so, it will show that 
the peculiarity is a general one, and not confined to the 
feet. It may be noted that people of the "rheumatic " habit 
are thought to perspire more than others. 



"The Middle Child." 

I have just seen the following in a newspaper : 

"Mr. George Bancroft accounted for his own longevity the other 
day with three reasons : First, that he was the middle child in his 
father's family, equally distant from the youngest and the oldest; 
second, that he had always gone to bed at ten o'clock, unless it had 
been impossible; and, third, that he had always spent four hours in 
each day in the open air, unless prevented by a storm. He added that 
his riding, of which the newspapers had made so much, was primarily 
for the purpose of being out of doors, and not of being on horseback." 

The early-to-bed feature, as well as the out-door exercise, need not 
be regarded as new ; but this is the first time I have ever heard of any 
special importance being attached to the "middle child," and would 
like very much to learn whether there is " anything in it." Coming 
from any less authority than Mr. Bancroft, I should have set it down 
as superstition and thought nothing further of it, though for that mat- 
ter I cannot say that there is evidence that Mr. Bancroft really did say 
it, as the above quotation was itself quoted from another paper. 
New York City. A Papa. 

We have never beard of the notion before; we believe 
there is " nothing in it " as it stands. But several facts may 
have given rise to the belief, if such belief exists. The 
earlier children of immature parents sometimes show corre- 



NURSERY PROBLEMS. 



spending feebleness of constitution, although youth of the 
parents, if they are really mature, is usually considered an 
advantage to the offspring. On the other hand, the later 
children, if many be born to the parents, not infrequently 
show the effects of impaired health of the latter, particularly 
if the mother's condition is broken by constant childbear- 
ing and incessant nursery care. Still further, the earlier 
children, it is sad to say, often show the results of the pa- 
rents' want of knowledge, and bear the marks of their ex- 
periments in child-rearing. Not infrequently two persons 
of little experience in anything, but of the "know-it-all" 
type, marry, and the result cannot be expected to be perfect. 
A lady once half-pathetically said to the writer, when speak- 
ing of her first child: "The others will never know the 
debt they owe to him for teaching me." 



An "Ideal Diet" at Eighteen Months. 

What do you consider, in the abstract, an ideal diet for a healthy 
child at eighteen months ? My baby will be two years old in August. 
Denver, Colo. Ax Interested Mother. 

Supposing the child, eighteen months old in winter, to 
have cut its eye teeth and to have a pretty good digestion, 
the following will be about what he can have : 

He will have five meals, at about 7 and 10 a. m., 2, 6 and 
10 p. M., or, if he be a very good night sleeper, the afternoon 
meals may be at 1, 4 and 7 p. m., and nothing until morn- 
ing. In the latter case the four o'clock meal will be a light 
one. The first, third and fifth meals correspond to adult 
meal times in the second schedule, with two " gouter" (or 
luncheon) meals interjected. In the first schedule the first, 
third and fourth are the meals, and the "gouters " come at 
10 a. M. and 10 p. m. 



MISCELLANEOUS, 249 



The first (breakfast) will consist of milk, half pint, as 
the main article every day, and with it may be given, for 
variety, bread and butter or a soft-boiled egg yolk. The 
bread should be stale, and a generous slice may be given if 
the egg be not given ; a thin slice if it is. Some children 
may take in place of the egg or bread some of the finer 
cereal preparations, but they must be most thoroughly 
cooked if given at all. 

The first luncheon (10 A. M.) will consist of a small cup 
of milk with or without one or two "Educator " biscuits or 
a little bread and butter, according to the appetite of the 
particular child. 

The meal at 1 or 2 p. M. is the dinner and the principal 
meal. It will consist of a small quantity of mutton, beef or 
chicken white meat (the former two rather underdone), 
scraped or very finely minced and slightly salted, with plat- 
ter gravy, if the meats are roasted (the juice of the meat 
takes its place in the chop or steak). If really fresh fish are 
to be had, a piece of nicely broiled fish may sometimes be 
substituted for the meat. "Long-distance" or "cold- 
storage" fish are not, in our judgment, admissible. In 
place of the meat good broths may also be substituted, to 
give variety. With this main article (*. e., the meat or its 
substitutes) is also to be given bread and butter. Some ad- 
vise allowing the roasted potato, but in our experience it is 
better to delay it until after the full set of teeth has come; 
suy, until about two years. We prefer well-boiled rice as a 
vegetal ile. With this meal a little dessert may be allowed; 
plain rice and milk pudding, not too sweet, and rennet cus- 
tard (called "slip" and "junket " in various localities) are 
among the safest desserts. 

The fourth meal, if given at six, will be practically a 
repetition of the first, i. e., milk and bread and butter and 
possibly the egg, which we do not particularly like at night 



250 NURSERY PROBLEMS. 



for young children. The fifth meal will then be only a cup 
of milk at about 10 p. m. If, however, the second schedule 
be used, the fourth meal, about 4 p. m., will be milk, with 
possibly bread, and the fifth, just before going to bed (6 to 
7 p. M.), will be of milk and bread. 



Bicarbonate and Phosphate of Soda. 

Will you kindly enlighten me on the following points? My 
baby-boy, fourteen months old, has always been small and delicate. 
He was weaned two months ago, and on account of his extremely weak 
digestion I was obliged to add an alkali to his milk, which I dilute 
with one-third strained oatmeal. On account of his habitual consti- 
pation I use carbonate of soda instead of lime-water. I received the 
suggestion from a good authority, but I am aware that both lime- 
water and soda were recommended "temporarily to counteract 
acidity." Now I am becoming anxious about continuing to add the 
soda, though I still fear to omit it. 

(1) Please inform me whether its continued use may be injurious 
to my little one, and enlighten me as to what bad effects it would pro- 
duce. 

(2) Is phosphate of soda an alkali ? 

Brooklyn. N. Y. Mab. 

(1) The persistent use of any drug should be avoided, un- 
less there is evident reason for its administration. As to the 
bicarbonate, we should say that it is, perhaps, as little harm- 
ful as any. But its use is chiefly as an antacid rather than 
a laxative. It is put into milk only to make sure that the 
latter is not sour and to prevent too sudden curdling. It is 
safer to have blue litmus-paper in the house, with which to 
test the acidity of the milk, and to add the soda or not as re- 
quired. Blue litmus-paper is reddened by any liquid having 
an acid reaction. The druggist who sells you the paper will 
explain its use to you. The sudden curdling is perhaps bet- 
ter prevented by the addition to the milk of barley or oat- 
meal water, which act, as is supposed, by mechanical hin- 
drance to the formation of large curds. Soda has a medici- 



MISCELLANEOUS. 251 



rial value also if the stomach secretion is believed to be too 
acid (it is acid naturally), which is evidenced by hard or 
large curds or uncommon acidity in the vomited matters, 
or similar curds in the passages. All alkalies if abused are 
supposed to have the effect popularly called " thinning the 
blood," but the soda salts are generally better tolerated than 
those of potash. 

(2) Phosphate of soda has a slight alkaline reaction, but 
it is not counted as an alkali. It is a useful laxative or 
purgative, according to dose. 



Precautions in a Case of Diphtheria. 

Our little three-year-old Mabel is just recovering from a severe at- 
tack of croupal diphtheria. She is hoarse aud coughs a good deal. 
Her stomach troubles her and she is very restless at night. She eats 
very little, mostly milk with bread or oatmeal gruel strained. I know- 
nothing about the after-treatment of diphtheria. Perhaps you could 
enlighten me on the following points : 

(1) How long is it before the danger of infection is over? "We 
have kept our baby away from her, and it is now one week since she 
began to mend. 

(2) How long does the throat remain inflamed usually, and the 
hoarse cough continue ? She cannot speak plainly yet. 

(3) What are the symptoms of a relapse ? 

(4) What is the best preventive against the infection of others, 
and also the recurrence of the disease with every cold, etc. Some 
recommend belladonna. 

(5) In case of paralysis and the other after-troubles, what is best 
to do until medical aid can be procured ? 

((!) Is a change of climate always desirable when it can be had? 
Ilermotiillo, Mexico. M. A. C. 

(1) No one can answer this question categorically. As- 
suming a genuine diphtheria, contagion is possible as long 
as any of the poison is about, and it may cling to clothing 
or articles of furniture for a long time. Afterthe sick child 
is pronounced thoroughly well it should be carefully bathed, 
its hair cleaned and its clothing all changed, and taken to 



252 N URSER Y PR OR L EMS. 

another room— not yet to other children — while the sick- 
room and its contents are fully disinfected. The child 
should be kept away from other children for some days 
longer at least. 

(2) Often a long time — the time is so variable that to 
state an average would be rather a guess than a rule. 

(3) A real relapse consists in the reappearance of a mem- 
brane somewhere. If it is low down in the throat the 
symptoms may be those of croup. If higher up, or on the 
tonsils, or in the front part of the nostrils, the membrane 
can be seen, or if high in the nostrils it can be inferred from 
the kind of discharge. 

(4) The disinfection and care described under (1) is the 
best safeguard. There is no tendency for it to come back 
" with every cold," unless the poison of diphtheria is lurking 
around. Belladonna probably has absolutely no effect on 
the poison. It is useful for some sore throats. 

(5) The domestic treatment of the paralysis is practically 
nothing, except nutrition — careful feeding little by little to 
avoid choking, if the throat is the seat of the paralysis. For 
the paralysis of the limbs we know of no domestic treat- 
ment to be recommended. 

(6) A change of climate — to a healthful one — if the 
change can be accomplished without too great fatigue, 
usually is of value in promoting recovery from debilitating 
ailments. It is not called for in diphtheria more than in 
other diseases, but change might prove beneficial by remov- 
ing the patient from the influence of the special poison 
which had been left undestroved in the home. 



Average Weight and Height at Two-and-a-Half 
Years. 

Will you tell rue the average weight and height for a girl two 
years and a half old ? 



MISCELLANEOUS. 



There are, so far as we know, no extensive and careful 
statistics on this point. Babies of the first year have been 
studied carefully, and children of the school age — i. e., five 
years and upward. We should estimate that thirty-two or 
thirty-three inches, and twenty-eight to thirty pounds would 
be fair averages. Perhaps we are setting it high, for the tall 
and heavy children are more likely to be measured and 
weighed than the small ones, and hence the figures within 
our own knowledge may be misleading. 



For an Attack of False Croup. 

I should like to ask what to do for my baby when she wakes up at 
night with a cough like the bark of the croup ? What do you consider 
to be the best and quickest remedy until the doctor can be summoned 
in the morning ? 
Foxboro, Mass. B,. W. S. 

Where only the bark is present, often and indeed usually 
nothing is necessary to dislodge the mucus from the throat 
beyond the waking and the child's natural cry. If this is 
not sufficieut the drinking of a glass of milk (or even water), 
as hot as can be swallowed comfortably, or the placing of a 
sponge wrung out of hot water — as hot as can be borne by 
the child — upon the throat, will usually relieve it. It is, how- 
ever, well to have in the house an emetic, and that which 
combines tolerable rapidity with the requisite safety is the 
syrup or wine of ipecac. If there is difficulty of breathing, 
from half a teaspoonful to a teaspoouful may be given, and 
repeated in twenty minutes if relief is not gained. If 
vomiting is not required, doses of from two to live drops 
may be given hourly or less frequently, according to the 
severity of the cough. 

You should bear in mind that if nausea is produced, 
either with or without vomiting, it is likely to be manifested 



054 N UBS EB 7 PR OBLEMS. 



by paleness, clammy skin, and some prostration, just as in 
adults. If this was not remembered undue anxiety might 
be felt previous to the vomiting. 



Alcoholic Stimulants in Fevers. 

My little girl of five years has the scarlet fever, and our physician 
prescribed for nourishment milk punches every two hours. I would 
like your opinion on the subject of giving spirituous liquors to chil- 
dren in cases of fever. I am under the impression that whiskey or 
like stimulants only add fuel to the fever. 
Brooklyn, N. T. A Teoubled Parent. 

Alcoholic stimulauts, properly used, do not "add fuel to 
the fever." The condition demanding their use is not one 
that can be discussed without a good deal of knowledge of 
physiology and pathology. Every judicious physician con- 
siders alcohol as a drug to be given or withheld in any case 
precisely as any other drug, according to the circumstances 
that exist and the ends to be accomplished. The unfortu- 
nate abuse of alcohol leads the laity as well as some physi- 
cians to treat it as if it were a thing by itself. The abuse of 
opium and other narcotics, of quinine, or of purgatives is no 
reason against then proper medicinal use. So with alcohol. 
If you can trust your physician with other drugs you may 
with this. 



Evils of Early Mixed Feeding; Effect of the 
Mother's Diet upon the Child's Teething. 

(1) Should a child from three to five months old be fed any at the 
table when there is a sufficiency of mother's milk? If so, what 



MISCELLANEOUS. 255 



should it be given ? My babe, now five months old, seems to delight 
in eating, and, as I think I have enough milk for her, I hesitate in 
giving her solid foods, though I am advised to feed her by ladies who 
feed and also nurse their babies with no apparently bad results. My 
baby is troubled with constipation and I am told that feeding her will 
overcome it. 

(2) Is it right and proper to " chew " food for babies ? 

(3) Cannot a mother that suckles her babe hasten or retard its 
teething by selecting her diet ; i. e. , if early development of teeth is 
wanted, partake of bone-making foods, and vice versa ? 

Hubbard City, Texas. B. 

(1) A child should have nothing whatever from the 
adult table before a year and a half at the earliest, preferably 
not until two years. Solid food should not be allowed until 
after a year, and then it should be bread, gruels, porridge, 
and possibly an egg; but these should be prepared for it and 
given it by itself, not at the adult's table. To let a child 
come to the table is only to teach it to beg for things it 
should not have. Let it be fed before your meals, so that it 
shall not be tantalized at seeing you eat when it is hungry. 
Treat any person who gives your baby " tastes" of things as 
your "dearest foe." To give solid food to a child on the 
breast is too incongruous to be seriously considered. Con- 
stipation is undesirable, but a small matter compared with 
what usually results from such mixed feeding. 

(2) If you mean the chewing of food by an adult and 
then putting it into the baby's mouth, it certainly is not 
right. It is simply disgusting. 

(8) Good health and good milk supply in the mother 
help to develop the child well and rapidly, teeth included. 
Hut so far as we know or believe, there is no diet of the 
mother which will help the teeth of the child in particular. 
The only way of retarding the teeth that we know of is to 
give the baby poor nourishment, and this retards its de- 
velopment in every other way. 



NUSSER Y PROBLEMS. 



Imperfect Sterilization ; Large Meals; Sulphur 
for Disinfection. 

(1) Would you advise the use of milk-sugar after the age of one 
year? 

(2) If not, how much granulated sugar ought to be put in half a 
pint of milk, or of milk-cream-and-water? 

(3) If part of the milk-sugar settles in the process of sterilization 
and bakes into a solid little cake, is it because there is too much sugar 
put in ? 

(4) My sterilizing is done at about 9 A. m., Baby's breakfast being 
prepared the morning before. We do not have ice, and several times 
during the summer my baby's breakfast soured over night, why I 
could not discover, as my "Arnold Sterilizer," with its graduated 
bottles, was over a hot fire just an hour, steaming actively. Do you 
think it could be due entirely to carelessness in the plugging with cot- 
ton which I could not always attend to myself? When I occasionally 
tried a larger, wide-mouthed bottle, the milk soured before night. 

(5) I would like to ask if the majority of mothers succeed in re- 
stricting their babies to 8 or 10 ounces at a meal ? My ten-months-old 
baby, weighing 21 pounds, has had only four meals in twenty-four 
hours since about four months of age, and for two mouths past has 
taken from H> to 20 ounces at every meal, screaming uncontrollably 
when I try to stop her at auy amount under 15 ouuces. She never ap- 
pears to suffer from over-eating in any way. I have had a similar ex- 
perience with three other children, their weight at oue year having 
been 24, 25 and 21 pounds. 

(6) We have had one mild case of scarlet fever in our family, and 
our doctor has depeuded for disinfectants entirely upon fresh air, sun- 
shine, and an open fire. The patient has been isolated in a bare- 
floored room for four weeks and will be longer, the other children 
being in perfect health to-day. As to fumigation by sulphur, the 
doctor says that the "Sulphur Congress" has just decided that the 
fumes of sulphur have no effect ou disease-germs. If this is so, why 
is not this fact proclaimed ? Is it because, as our doctor says, "It is 
better for some people to keep their faith in sulphur, as they cannot be 
induced to open the windows uuless there is a very strong odor to dis- 
pose of " ? 

Gildersleeve, Conn. C. A. F. 



MISCELLANEOUS. 257 



(1) It is unnecessary. 

(2) If undiluted milk is used, no additional sugar is 
needed; and as at the age of one year milk can be taken 
nearly pure by an average well child, we think that the 
cream mixture is no longer necessary, and that for the milk 
and water very little sugar, if any, is called for. Its use is 
rather as a bribe than as a necessary ingredient. 

(3) Milk-sugar is not as readily dissolved as ordinary 
cane sugar. But if dissolved before the sterilizing begins, it 
ought not to settle, as might happen if the hard grains had 
only been mixed with the milk. It may be, too, that the 
sugar of milk was not pure. 

(4) Assuming that everything was sweet and as it should 
have been when the sterilizing began, we can think of no 
other cause of spoiliug except inefficient sealing. The cot- 
ton plugs may have been too loosely packed and not really 
stoppers; or they may have become wet, when their effi- 
ciency ceases. 

(•5) We cannot tell the experience of the majority of 
mothers, but, judging from the experience of many and 
from observation, we think 12 ounces a very large meal for a 
child of the age and weight of yours. At that age 40 ounces 
is the average day's ration, generally divided into five por- 
tions. Your child is taking from 64 to 80 ounces. It is pos- 
sible that a child may digest this amount. Usually 64 
ounces is a tax upon the digestion of a yearling infant, and 
i he almosl uniform result of such doses is a distended 
stomach and protuberant abdomen, even if there are no dis- 
tinct evidences of indigestion. 

(6) We are well aware that sulphur fumigations if poorly 
carried out, and perhaps as usually done, are useless. Hut 
while the debate as to the value of sulphur fumes has gone 
on, we have noi been convinced that, if properly used, they 
were useless. They must be used with moisture, hence we 



NURSERY PROBLEMS. 



usually make steam at the same time with the vapor; and 
they must be made to penetrate every portion of the apart- 
ment to be disinfected. It is easy to admit that more 
powerful disinfectants exist, but their use is generally not 
practicable. It may be also admitted that one living in a 
country village can do more with air and sunshine than a 
city dweller, because the former gets more of these natural 
purifiers, and because he endangers fewer persons by this 
method of disinfection than would the latter. In this par- 
ticular disease, moreover, the fact that many escape con- 
tagion under all circumstances is helpful to the success of 
whatever plan of disinfection be adopted. 



Patches on the Tongue. 

For a year past I have noticed in regard to my little boy, who is 
now two years of age, that the tongue is very often covered here and 
there with small white patches. Sometimes they are red in the center 
with a white rim. The child has always been very pale, but with that 
exception has seemed very well and full of life, scarcely ever having 
suffered from even a cold. He weighs 30 pounds, and his flesh is firm 
and solid. He enjoys a good appetite, and I have always tried to be 
careful concerning his diet. He takes cereals for breakfast at 8 A. m., 
and nearly always calls for a second saucerful, seldom taking anything 
else, except a cup of milk and an oaten flake cracker. Occasionally he 
will eat the yolk of a soft-boiled egg with bread for a change, and he is 
fond of apple sauce, but generally takes what I first mentioned. 

Until within a couple of months he took a lunch of oatmeal 
crackers and milk at eleven and his dinner at two. He has now dis- 
pensed with the lunch and takes his dinner at one, eating a plate of 
chicken, beef or mutton broth with rice, bread and butter and a cup of 
milk. He varies this with cream toast, or bread and butter and a lit- 
tle beef, mutton or chicken cut up fine, but eats very few vegetables, 
almost none. He likes plain rice pudding, junket or custards, which 
I occasionally give him for dessert. He takes his supper at 5.45, of a 
couple of slices of bread crumbed in warm milk, after which he is off 
to bed, and is a good sleeper. He never asks for anything between 



MISCELLANEOUS. 259 



meals, though I have given him an apple at times, which he has seemed 
to enjoy. I peeled it and cut it in small pieces. It did not seem to hurt 
him, though I thought it best to ask your advice before continuing it. 
Can you enlighten me in regard to the patches on the tongue — the 
cause, and what to do to overcome the trouble? 

Wyncote, Pa. A. L. G. 

In all probability the patches are those of common 
sprue, although the child is rather old to have this disorder. 
The real cause is a microscopic plant akin to the yeast plant. 
It may be acquired from the air at any time, but some con- 
ditions not those of perfect health, seem necessary to its 
growth, the chief of which is acidity of the secretions of the 
mouth from any cause. Sweet food, starchy food, the re- 
mains of milk, etc., may ferment in the mouth and give the 
requisite condition for the development. Prevention is best 
secured by being careful about sweets and cleansing the 
mouth after eating, using an alkali to secure alkalinity of 
the mouth. Lime water will do, but a favorite one is borax, 
which unites with slight alkalinity the disinfecting power 
of the boric acid. A solution of borax with a little extra 
boric acid added is very good— say, dissolve a heaped tea- 
spoonful of powdered borax in a teacupful of water, then 
add half a teaspoonful of boric acid and stir until the 
whole, or as much as possible, is dissolved. First clean off 
the spots as well as you can with a soft rag over the tip of 
your linger. Then wash the tongue well with a rag dipped 

in the solution. It is better if you add to it adessertSj nful 

of glycerine. If the mouth is kept alkaline, as it naturally 
is, the plant will hardly grow. Of course, the kinds of food 
likely to favor the growth should be restricted during the 
presence of the growth, that is to say, starchy or sweet 
foods. 

There seems to be nothing out of the way in the diet, if 
the digestion is adequate, and you do not speak of anything 



N I 'EVER Y PR EL EMS. 



to the contrary. There are few fruits which are distinctly 
useful except when fresh, although many are admissible. 
So of vegetables ; there are very few, we think, which are 
really advantageous at two years of age. Yet some children 
can bear them without evident indigestion. The parent 
usually thinks of a dietary as containing all the things that 
can be given without positive and immediately recognizable 
harm; the medical adviser, on the other hand, thinks of a 
dietary as made up of articles really desirable as food 
and some innocent indulgences to tempt the palate. Be- 
tween these plans a good deal of room for judgment is left, 
and the best of this judgment lies in the application of gen- 
eral rules to the particular case. Our own inclination is 
always to give rather less than the digestion could carry, 
that is, to leave a little reserve digestive power. 



Various Points of Nursery Regimen. 

(1) What fruits are allowable for a child from the age of two to 
that of three years ? 

(2) If necessary to wean a child at the age of three or four 
months, would you advise using the bottle, or trying at once to feed 
from a spoon ? 

(3) At what age can a baby be taught to sleep all night, and how 
is this best accomplished ? Is it advisable to let a baby cry long in 
the night to attain this end ? My baby is four months old, goes to bed 
at 6 p. M. after nursing, and wakes at 10.30, 3 and 6 a. m. to nurse 
again. I would like to train her in the best way. She nurses at 9 and 12 
A. M. andat 3p. m. in the day, in addition to theother times mentioned. 

(4) Can a baby be taught to take her bath and then go to her crib 
for a nap without nursing immediately after her bath ? My baby 
cries very hard if I am ever detained so that her nursing does not 
come just after the bath, and I should prefer to do the other way, if it 
can be accomplished without injury to the child. 

(5) "When should a mother start with regular hours for nursing, 
bath, ride, etc., and let nothing interfere? I find it well-nigh iinpos- 



MISCELLANEOUS. 



sible with my baby, as some days she will sleep one hour after her 
bath, some two, some three, and once in a while as long as four hours. 
I am told it is not well ever to waken a baby, or in any way disturb 
its nap, as Nature shows that sleep is the medicine it needs. I shall 
be very glad to be enlightened on this subject. Is it true that it ruins 
a child's disposition to awaken it from sleep ? 

(6) Should not a child's napkin be changed every time it is wet? 
My nurse told me not to do so, but it seems to me unreasonable. 
Philadelphia. R. T. A. 

(1) Opinions differ as to details, some physicians being 
more liberal in giving fruits than others. But the following 
general suggestions will help you. It must be borne in 
mind that different children are very different in their 
ability to properly digest food; also that fruit which may be 
quite proper for most children may be not so for a child hav- 
ing a tendency to rheumatism, to certain skin diseases, and 
so on. And further, that the freshness and good condition 
of fruits is of the greatest importance if they are to be used 
for children. So much being premised, we may say that 
most children over two years of age may have the juice and 
pulp of a carefuly selected and really ripe orange. It is not 
the same thing to cover the tartness of an unripe orange 
with sugar; it only aggravates its faults from a digestive 
point of view. The seeds are, of course, to be very carefully 
removed, as well as all traces of the white fibrous structure. 
The best method of preparing an orange is to cut it cross- 
wise (not from end to end) in the middle and carefully lift 
out the pulp with a spoon. The orange is the only winter 
fruit which we can recommend; the banana is decidedly ob- 
jectionable for young children. Few children of the age of 
two or three years should have uncooked apple. But if 
there is a tendency to constipation, stewed and sweetened 
apple sauce, well freed from any traces of core and fibrous 
matter, stewed prunes (the pulp only), or the soft inside of 
ii^s may be given in moderate quantity. In our judgment 



262 XI'RSERY PROBLEMS. 

they are desirable at that age only as laxatives, and should 
be given as such rather than as food. 

For summer fruits there is a larger choice — a large choice 
indeed, if one can have very fresh fruit. At the head, we 
think, should be placed the thoroughly ripe and fresh peach. 
It is generally entirely unobjectionable and often desirable. 
Of melons, both the watermelon and the juicy varieties of 
muskmelon, we think we could say nearly the same were it 
not that away from the melon patch a really good melon is a 
rarity. But when ripe, sweet, and not in the least wilted, 
they are, we think, excellent. The pear is not so good, being 
accounted rather indigestible. The small stone fruits, cher- 
ries, plums, etc., must be used circumspectly and carefully 
prepared; and the same is true of the apricot, which gen- 
erally has made too long a journey to be fit, uncooked, for 
children on this coast. Of berries, we would not give at this 
early age any but the best strawberries and should bear in 
mind, in giving them, the frequent personal peculiarities 
which are noticed regarding this fruit. 

(2) Generally, at that age, we should use a bottle, but 
after seven or eight months we should not. Perhaps at six 
mouths, if a child had already learned to drink well from a 
spoon, we might prefer it. 

(3) At almost any time ; but we do not recommend it 
until after six months, and even then it is often better to 
nurse children at the mother's bedtime until they are con- 
siderably older. There is a wide difference in children, but 
while they are on the breast there is difficulty in telling 
whether their clamor is due to habit or really to the small 
amount of milk that is gotten from the breast. Accurate 
weighiug of a child before and after nursing will show the 
weight gained, which is, of course, the weight of the milk. 
But assuming a full supply of milk, the teaching the child 
to sleep at night is no harder before than after weaning. 



MISCELLANEOUS. 263 



(4) A child can, of course, be taught not to expect its 
meal immediately after its bath. There is no natural re- 
lation between the two but habit. It is merely a question 
which is the more trouble to you, to teach her or to go on as 
you are going. 

(5) There is no sense in having a rule so fixed as to over- 
ride everything, but regularity should have begun the day 
the baby was born. If a baby oversleeps from fatigue or 
illness, it should not be waked up just for a rule, but only a 
reasonable variation should be allowed. A baby that has 
slept a proper time can be gently aud gradually wakened 
without startling it. To awaken a child suddenly is, of 
course, stupid and harmful, as any other fright would be ; 
but any quiet person can usually awake a child gently by 
increasing the light, by moving around the room, by quiet 
talking, etc., so that the nap comes naturally to an end after 
a few minutes. Exceptions occur, of course, but the rule 
stands. 

(6) Of course, every time it is wet ; the napkin must not 
be left to dry on the child. But it is not usually necessary 
that it be done the moment it is wet. The child need not be 
disturbed in its sleep, for instance, if it be well covered, ex- 
cept in cases of such skin diseases as will not allow of a 
damp cloth being left for any time. 



Early Use of the Nursery Chair. 

Will you please tell me what you consider the best method of 
breaking babies of the habit of soiling their napkins, and at what age 
we should begin to teach them ? 

Tsing Kiung, China. S. G. 

The only way that we know of is this: They are must 
likely to pass water a short time after a meal and again after 
an interval. If very soon after a meal a vessel is placed at 



264 NURSERY PROBLEMS. 

the child's seat while it lies on the attendant's lap, it soon 
learns to wet at that time. Of course, it may often wet in 
the interval, and you may have many failures, but ulti- 
mately the child learns. If the vessel is also presented a 
little before the time that the child usually empties its 
bowels, and the evacuation is solicited by applying a little 
vaseline to the anus (if the simple presence of the vessel be 
not enough), the desired cleanliness can usually be soon at- 
tained. 

The teaching may begin early. Children of three 
months are quite teachable, it being understood that success 
comes gradually. 



Loss of Appetite; Imperfect Nutrition. 

My baby-girl is nearly eleven months old ; she weighs twenty-two 
pounds and was doing nicely until lately, when she seems to have lost 
all her appetite, taking hardly a bottleful through the day. I feed 
her on milk and Mellin's Food. "What had I best do ? She has but 
two teeth, her hands have always been cold and clammy, yet she is 
said by all to be a healthy-looking child. 

Worcester, Mass. D. S. P. 

The little girl has one evidence of good health — namely, 
fair weight. On the other hand, if a child of eleven months 
has but two teeth there is reason to think that in some way 
its nutrition is defective. In this case, moreover, the hands 
have been cold and clammy, which may be taken as an evi- 
dence of an imperfect circulation. At the moment of our 
correspondent's writing the appetite had failed. There are 
many points which are not stated, but we may give " D. S. 
P." a few hints regarding things to be looked after in her 
baby's case. The slow coming of teeth — in this instance not 
so very slow— is usually suggestive of that form of malnu- 
trition called rickets. 

The loss of appetite in a small child will ordinarily be 



MISCELLANEOUS. 



better overcome by the removal of the cause than by the ad- 
ministration of tonics. The mother should, therefore, look 
to the condition of the digestive apparatus as well as she is 
able. She should notice if Baby's tongue is clean or furred; 
whether the movements are natural as to color, consistency, 
and smell, or whether they are too dark or too ligbt-colored 
and chalky, constipated, or too liquid, offensive in smell, or 
too sour. Even if she is unable to correct the abnormal con- 
dition, it will enable her to give to the physician, when 
called, so clear an account of the state of affairs that he can 
prescribe with much greater certainty arid effect. The 
mother may, however, do something by herself. If there be 
constipation with the furred tongue, the familiar remedy of 
the spiced syrup of rhubarb with the bicarbonate of soda in 
proper dose will be pretty certain to relieve, at least for the 
time. If the movements are white and chalky, no remedy 
that can be prudently used without medical advice will be 
found more beneficial than the phosphate of soda; a small 
pinch of the powdered phosphate may be dissolved in a bot- 
tle of milk, once, twice, or thrice a day ; it is not objected 
to, as it resembles common salt in taste. If the stools are 
sour, the use of an alkali — lime-water if they are loose, bi- 
carbonate of soda if they are constipated — may be of assist- 
ance. Better than all dosing, however, for correcting a dis- 
ordered digestion usually is the change of food — bottle-fed 
children are here alone considered — and our preference is to 
give good sweet milk, diluted with water, or barley-water, in 
place <>!' any prepared or starchy food. By means of this 
change and the use of the simple remedies mentioned, much 
can lie done to improve the condition of a baby's diges- 
tion ; still, it seems to us the part of wisdom not to carry 
domestic practice very far if good medical advice can be ob- 
tained, but rather to procure explicit directions suited to the 
particular case, and exactly to follow them. 



X URSER Y PR OBLE MS. 



A word about the cold hands. By themselves they are 
not important ; they are only to be considered as indicating 
something beyond. The commonest causes in little children 
are poor nutrition, feeble circulation, or undue perspiration. 
The cure must lie in the improvement of the nutrition and 
tone, but some help may come from the addition of salt to 
the daily bath and the sponging of the parts, rather than 
their immersion in water. 



Colic and Patent Medicines. 

(1) Will you kindly tell me why a two-months nursing baby in 
very good health should have colic? Which is best to use for it, asa- 
foutida or medicines containing paregoric? 

(2) Is it ever right to use soothing syrups even when a doctor pre- 
scribes them ? What is soothing syrup ? 

(3) When Baby's bowels are not naturally moved and she is 
constipated, will it do to give an injection every other day, or should 
it be done oftener ? Might not harm come from a more frequent use 
of the injection, and would it be better to use medicine ? 

Cliambersburg, Pa. W. C. M. 

(1) We cannot tell why your particular baby has it, un- 
less it be from constipation and the collection of flatus in its 
bow els. Of course, the existence of colic is fair evidence of 
indigestion. But why young babies at the breast have colic 
(and the probable indigestion) is often not easy to say. In 
many cases, doubtless, an analysis of the breast milk, or a 
critical inquiry into the details of the baby's hygiene, would 
give a reason. But as cases are crudely presented to the 
practitioner many children are simply reported as "colicky 
babies." Even in these the tendency to colic usually 
diminishes or disappears after they are three months of age, 
which is itself another evidence that the trouble was due to 
an indigestion, disappearing with increased digestive power. 



MISCELLAXEUOS. 



Of course, when the child is artificially fed, colic is easily 
explained. Asafoetida is better for domestic use. It is safer 
than paregoric, although the latter has but a small propor- 
tion of opium, having been devised especially for use when 
small doses of opium are called for. It has the further ad- 
vantage of being slightly laxative, while paregoric is di- 
stinctly constipating, the opium and camphor being both 
active in producing this result. 

(2) We cannot deny the right of a physician to use any 
remedy for which he will make himself responsible ; there- 
fore we cannot say that you should not use a remedy which 
he orders. But he should give you (in writing, to prevent 
misunderstanding) explicit directions as to the size of the 
dose and the intervals between its repetition. The composi- 
tion of these remedies is supposed to be secret. For our- 
selves we cannot use a mixture of which we do not know 
the composition until we have failed with the drugs which 
we know about. 

(3) We prefer the daily use. We think the constipation 
more likely to do harm than the enema. A glycerine sup- 
pository might be better still. 



Nursing Bottles. 

Can you advise me which is the best nursing bottle for an infant 
to use '.' I have tried a lot of them — some with rubber tubes and 
others with the nipple right on the neck of the bottle — but still Baby 
sucks in so much air with them, and I find them all exceedingly diffi- 
cult to keep reasonably clean. Is there no bottle which would over- 
come these difficulties? 

Crii/liin, Pa. A. S. G. 

Never use one with a tube; use plain, well-fitting nip- 
ples, with very small holes, [f possible, gel them without 
holes Miid puncture them with a fine needle. Such a nipple 



268 NURSERY PROBLEMS. 

stretched over the neck of the bottle will not allow any air 
to be sucked from the bottle, if the latter is so held that the 
bottom is uppermost and the neck always full of milk. No 
air can then come in contact with the nipples. Some per- 
sons carelessly hold a bottle so that one side of the neck 
only is filled with milk, the other with air. If that be done, 
no bottle is free from the objection you raise. Of course, the 
infant should never be left alone with its bottle. It should 
be held all the time. The difficulty in cleaning bottles is a 
real one, but care will overcome it. The nipples should be 
put to soak in an alkaline solution, and the bottles filled with 
the same. Soda, saleratus, and the like are good. The sub- 
stance sold under the name of Pearline has been found to 
he particularly useful for this purpose. It is, of course, to be 
dissolved in water. 

It may be added that the swallowing of air is sometimes 
not due to faulty bottles, as some children do not properly 
close their mouths in sucking and will swallow air even if 
on the breast. 



The Kindergarten at Home. 

Are there any books that will tell me how to give my children a 
little kindergarten training? There is no kindergarten in our country 
neighborhood, and there are not enough little children to encourage a 
teacher to open one. I can't leave my two-months-old baby long 
enough to go to New York and spend a morning in one of the training- 
schools there, but I feel every day more and more the need of teaching 
my four-year-old boy and two-year-old girl the use of hands and eyes. 
I have no nurse, and only one raw girl for general house- work, so that 
my time for teaching is both short and broken. However, perhaps I 
can find an hour a day in fragments. I have read somewhere that no 
one can understand Froebel's ideas without a long apprenticeship ; but 
half a loaf, or even a very small slice of a loaf, is better than no bread 
at all for the two children. If you will tell me what I need, and 
where to send for it, you will oblige 

A. H. K. 



MISCELLANEOUS. 



The Kindergarten Association of New York some time 
ago sent a circular to kindergartners all over the country, 
asking what was the best song and game book in use, and 
what songs and games were best liked. " Merry Songs and 
Games," by Mrs. Clara Beeson Hubbard, of St. Louis, was 
the book generally preferred, although several others were 
mentioned. Of course with only two children you cannot 
play all the games ; but there are enough in which two chil- 
dren can join to make the book worth buying. If you send 
for Edward Wiebe's "Paradise of Childhood " you will find 
directions for all kinds of kindergarten work. It is not a 
new book, but it has full directions for kindergarten occupa- 
tions and plates which will help you in teaching them. 
Everything is explained minutely in this book, and if you 
read it carefully you will have a clear idea of Froebel's theory 
and practice. The first and second gifts — a series of colored 
worsted balls, and a sphere, a cube, and a cylinder of wood 
— need no plates. The third, however — a box of cubic 
blocks — is fully explained by illustrations, which teach how 
to build representations of many objects. The children first 
see the small blocks placed together in the form of a cube, 
and are then taught to put them in various positions, each 
one leading to the next by a slight change. The lesson of 
destroying nothing, but producing one form from another, 
is taught by the blocks. The same principle is carried out in 
the fourth, iifth and sixth gifts, of oblong blocks of different 
sizes, which serve also to illustrate division into equai parts. 
The seventh gift introduces the child to a new form, the 
triangle, in a box of four-cornered and three-cornered tablets; 
and the text suggests many forms, such as bridges, houses, 
etc., which the child may build. The eighth gifl is a bundle 
of flat sticks, with which figures may lie laid; the ninth, a 
box of rings, introducing the curved line, which the child 
has heretofore been obliged to represent by several angles. 



NURSERY PROBLEMS. 



The tenth is a slate, ruled with a network of lines to help 
him in drawing. The eleventh and twelfth gifts are per- 
forated paper, a needle for pricking figures, and another one 
with silk or worsted. The thirteenth gift is paper for cut- 
ting and a pair of blunt scissors. The fourteenth is paper 
for weaving; the fifteenth and sixteenth are wooden slats 
for interlacing; the seventeenth is paper for intertwining; 
the eighteenth, paper for folding and teaching geometric 
forms; the nineteenth, peas or wires; and the twentieth, 
clay for modelling. Mr. Kraus and Mrs. Kraus-Boelte pub- 
lish a "Kindergarten Guide," which many persons prefer to 
Wiebe's. It is of more recent date than the " Paradise of 
Childhood." 

It is easier to order the materials than to try to have 
paper cut or blocks made by a person who does not under- 
stand the principles of the kindergarten. For example, the 
papers for folding should be exactly square and the edges 
perfectly true. You ought to have a little table for the chil- 
dren, divided by black lines into exact inch squares. You 
need not buy all the gifts at once. Begin with the balls and 
blocks, and use them for a few months. Then try the other 
gifts, one at a time, in order. The " Kindergarten Guide," 
by Miss Peabody and Mrs. Horace Mann, was the first book 
on the subject published in this country; and although it 
was written after a slight and imperfect acquaintance with 
Froebel's ideas, it is of great use to a mother or a teacher. 



INDEX. 



Abdominal fat, 227. 

Alcoholic stimulants in fevers, 254. 

Ambidexterity, 235 

Appetite, lack of, 6. 

Apples, 59, 69, 261. 

Bananas, 69. 

Band, infant's, 201, 203. 

Barley, composition of, 45. 

Barley gruel, 501. 

Barley water, 49. 

Bath — temperature, 187,188; re- 
action produced by a bath, 187, 
189, 190 ; dread of the bath-tub, 
189 ; soap, 192. 

Beets, 70. 

Bicarbonate of soda, 103. 

Birthmarks, 151, 153. 

Black-heads, 123. 

Bone-producing food, 57. 

Bottle habit, breaking of the, 12. 

Bow-legs, 145. 

Bread, new, 51. 

Bread crusts, 17. 

Broth, 53, 55. 

Butter, 55, 57. 

Cabbage, 70. 
Cake, 20. 

Carrots ami parsnips, To. 
Celery, 70. 
Cereals, 1 1. 45. 



Chair, sitting up in the, 181. 

Chicken-bone, 54. 

Cocoa, 59. 

Colds — taking cold easily, 111 ; 
cold in the head, 113 ; starving 
a cold, 114; nasal catarrh of three 
months' standing, 115; cold feet, 
127. 

Colic, 129-131, 266. 

Condensed milk, 24, 25. 

Constipation, 100-104. 

Cookies, 51. 

Corns, 176. 

Cream foods, 110. 

Cross-eyes, 162. 

Croup, false, 253. 

Crying — significance of Baby's 
cry, 193; inordinate crying, 194; 
crying and sedatives, 195. 

Deaf-mutism, 148. 

Diapers, 180, 204. 

Diet — weight and food at fourteen 
months, 42; change from a pure- 
ly milk diet, 42 ; changing from 
Lacto-Preparala to cow's milk, 
43 ; cereals, 44, 46 ; balls from 
Q-raham Hour. 45; Graham flour 
and bread, 46; oatmeal, 46-48; 
diet of a delicate two-year-old 
child, 48 ; barley-water, 49; bar- 



272 



INDEX 



ley and oatmeal gruel, 50; water 
for the baby, 50, 51; harm fulness 
of new bread and cookies, 51; a 
varied bill of fare, 52; broth, 53; 
meat-sucking, 53 ; a chicken- 
bone, 54; mutton-broth in addi- 
tion to the bottle, 55 ; butter and 
eggs, 55 ; potatoes, 57 ; tomatoes 
at three years, 58 ; fruit for a 
child of two years, 58; cocoa, 59; 
honey and molasses, 60; pop- 
corn, 60 ; fruit and milk, 61 ; a 
bill of fare for a two-year-old, 
62; strawberries at four years, 63; 
ripe water-melon, 64; rigs at thir- 
ty mouths, 64 ; oranges for in- 
fants, 65; ice cream, 66; a salt 
embezzler of three summers, 67 ; 
summer problems, 68 ; bananas, 
apples and oranges, 69; the abuse 
of sugar, 70 ; vegetables, 70 ; an 
ideal diet at eighteen months, 
248 ; evils of mixed feeding, 255. 

Disobedient children, puuishmeut 
of, 238. 

Drooling, 86. 

Drowsiness following a bump on 
the head, 237. 

Drying up the mother's milk, 225. 

Ears — ear-ache, 166; internal ear 
disease, 167 ; partial deafness, 
168 ; prominent ears, 169 ; large 
ears, 170 ; tampering with the 
shape of the ears, 171. 

Eating between meals, 16. 

Eczema, 120. 

Eggs, 55-57. 

Eruptions — characteristics of mild 
aud of serious eruptions, 119. 



Eyes — test for cross-eyes, 162; anx- 
iety about brilliant eyes, 163 ; 
pupils of different sizes, 163 ; 
styes, 164; clipping the eye- 
lashes, 165. 

Feeding — Dr. Page's method, 10 ; 
number of meals for an infant 
10; at night after weaning, 15; 
feeding a premature child, 20. 

Feet — confining the feet, 176 ; in- 
cipient corns, 176 ; distorted feet, 
177 ; ingrowing nails, 178. 

Fever, intermittent, 244. 

Figs, 64. 

Filters, 94. 

Fir pillow, 78. 

Flesh-forming food, 53. 

Floor, an unsafe place for Baby, 
182. 

Freckles, 149. 

Fruit, 261. 

Fruit and milk, 61. 

Garters, 211. 

Gas stove in the nursery, 92. 
Gertrude Suit, 203. 
Gritting the teeth, 135. 
Growth, slow, 7. 

Hair — thin hair, 172; washing the 
scalp, 173 ; use of soap on the 
head, 173 ; tampering with the 
color of the hair, 174 ; concern- 
ing bangs, 174 ; question of the 
unhealthfulness of long hair, 
175. 

Hair falling outafter confinement, 
228. 

Hard-reared baby, 229. 

Heat- rash, 121. 



INDEX. 



Hiccough, 132-134. 

Hives, 124. 

Honey, 60. 

Hunger at night, 9. 

Hygiene and sanitation, 91-99. 

Ice cream, 66. 
Indigestion, 105-110. 

Kerosene in connection with diph- 
theria, 95. 
Kindergarten at home, 268. 

Lime-water, 25. 

Magnesia, 103. 

Maize, composition of, 45. 

Malnutrition, 11, 264. 

Meat sucking, 53. 

Medical terms, popular miscon- 
ception of, 233. 

Melons, 64, 262. 

Middle child, 247. 

Milk — diluted with barley water, 
17; pure versus diluted, 23; con- 
densed, 24, 25 ; peptonized, 25 ; 
one cow's milk versus herd's 
milk, 27; top milk, 27; scum, 28; 
sour milk, 28 ; sterilizing, 29-31; 
dislike for milk, 39. 

Milk, How of the first days after 
delivery, 231. 

Molasses, (in. 

Movements of bowels, Dumber of, 
a day, 234. 

Mutton broth, 55. 

Nails, ingrowing, 179, 

Night-caps, 306. 

Night coverings, '-'"."i, '-'of., 207. 

Night-terror, i i:;. 

Niis. — bleeding, 134 ; itching, 135. 



Nursery chair, early use of, 263. 
Nursing, prolonged, 40. 
Nursing and bottle feeding, 22. 
Nursing bottles, 267. 
Nursing mother, diet of, 224. 
Nursing sore mouth, 226. 
Nuts, 68. 

Oatmeal, 46-48. 
Oatmeal- water, 23. 
Oats, composition of, 45. 
Oranges, 59, 65, 69, 261. 

Paper money from a sick-room, 96. 
Peaches, 262. 
Peptonized milk, 25. 
Perspiration, excessive, 236. 
Perspiring feet, 246. 
Pillows, 83. 

Plants in the bed-room, 93. 
Pop-corn, 60. 
Potatoes, 57. 
Powder, 99. 

Premature child — allowance to be 
made in feeding, 21. 

E,ailroad-trip, diet during a, 216. 
Red gum, 122. 
Rice, composition of, 45. 
Rickets, late teething one of the 

signs of, 84. 
Ringworm, 153. 
Mocking the baby, 180. 
Roof as a play ground, 184. 
Bound shoulders, 144. 
Rubber diapers, 202. 
Rye, composition of, 45, 

Sage-tea, 68. 

Salt, 67. 

Scum on milk, 28. 



274 



Sea-voyage, preparations for a, 
214. 

Second attacks of disease, 97. 

Second summer, 98. 

Shirts, 202 

Sleep — hours of the baby's naps, 
72 ; position for sleep, 73; crying 
to go to sleep, 73; short intervals 
of sleep, 74 ; wakefulness, 75 ; 
causes of restlessness at night, 
77 ; the hammock as a sleep-in- 
ducer, 78; putting a baby to sleep 
with the rubber nipple, 79 ; with 
sugar-rags, 79 ; experimenting 
with anodynes, 80; sleeping with 
arms up, 80 ; jumping in sleep, 
82; 

Solid food, change to, 13. 

Sore mouth, 128. 

Sterilizing milk, 29, 30, 31, 256, 

Stockings, 209. 

Stocking supporters, 210. 

Strawberries, 63. 

Stumbling, a confirmed habit of, 
146. 

Styes, 164. 

Sucking wind, 21. 

Suckling power, promotion of, 218. 

Sugar, abuse of, 70. 

Summer dress, 206. 

Summer problems, 68. 

Suppositories, 100-102, 104. 

Teeth — care of, 155; effect of feed- 
ing upon, 156 ; use of the tooth- 
brush, 156 ; decaying teeth, 156 ; 
discoloration of, 157 ; loss of a 
first front tooth, 160; removing 
redundant teeth, 161. 

Teething — teething pains, 73, 87 ; 
late teething, 84 ; arrested erup- 



tion of teeth, 85 ; drooling, 86 ; 

effect of the mother's diet upon 

the child's teething, 255. 
Temperature of the nursery and 

the bedroom, 92. 
Thumb-sucking, 232. 
Toe, depressed, 211. 
Tomatoes, 58, 70. 
Tongue, patches on the, 258. 
Tonsils, swollen, 137. 
Top milk, 27. 

Umbiiical growth, 144. 

Vegetables, 70. 
Vomiting, 14, 17-20. 

Walking — turning-in of the toes, 
197 ; weak limbs, 199 ; a baby 
who neither walks nor creeps at 
twenty-one months, 199. 

Warts, 151. 

Water for babies, 51. 

Water on the stove, 93. 

Weaning — age for weaning, 32 ; 
first food, 32, 34; dropping the 
night meal, 34 ; preparing for 
weaning-time, 34 ; systematic 
weaning, 36 ; partial weaning at 
ten months, 38 ; dislike for milk, 
39 ; refusing to take food, 41. 

Weight — after weaning, 8; at four- 
teen months, 42 ; normal gain 
per week, 237 ; 

Wet-nurse, selection of a, 239. 

Whapper-jaw, 148. 

Whooping-cough — contagion of, 
117; severity of, in relation to 
age, 118. 

Winter dress, 207, 208. 

Worms, 140-142. 



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